Indian Journal of Medical Microbiology最新文献

Background: In the age of modern medicine, CRISPR-Cas system-aided phage engineering has emerged as a major game changer for developing personalized antibacterial treatments. Modifying genomic DNA at a specific location leads to the inactivation of target genes, the acquisition of novel genetic features, and the correction of lethal gene mutations. Phages can be modified to precisely detect and control bacteria because of the vast possibilities of CRISPR-Cas-based genetic engineering.

Objectives: The primary objective of this review is to explore the basic principles, mechanisms, limitations, and perspectives of CRISPR-Cas system-aided phage engineering in producing tailored antibacterial therapeutics. Furthermore, this study will address how editing phage genomes using CRISPR-Cas technology allows for precise bacteria targeting, broadening phage host range, and improving infection control tactics.

Content: The arrival of the CRISPR-Cas system has transformed the field of phage engineering and aided in the precise modification of phagе genomes to broaden the phage host range. This novel strategy uses the accuracy of the CRISPR-Cas system to design engineered bacteriophages, giving targeted options for infection control. These recent advancements have the potential to alter the era of modern medicine.

Peripheral vascular disorders associated with anti-centromere antibody (ACA) present generally with sclerodactyly in connective tissue disorders (CTD). It is unusual for ACA-associated digital necrosis to develop without preexisting raynaud's phenomena or vascular risk factors. We report a novel case of a 60-year-old non-smoker, non-diabetic woman with ACA and isolated finger necrosis without any other features of CTD. This case underscores the importance of considering an autoimmune contribution to the development of digital necrosis even without any identifiable CTD. It highlights the need to consider ACA-associated digital gangrene to be considered as a distinct entity of an autoimmune disorder from scleroderma.

Objective: The present study aimed to assess the predictive value of Ig Mycoplasma pneumoniae (MP)-DNA, high-density lipoprotein (HDL), natural killer (NK) cell, and platelet (PLT) levels for the diagnosis of severe MP pneumonia (SMPP) in children with MP pneumonia (MPP).

Methods: Children with MPP admitted to our hospital from August 2022 to February 2024 were selected and assigned to the non-SMPP (NSMPP) and SMPP groups according to whether they had severe pneumonia. The following parameters were analyzed and compared between the two groups by the rank-sum test: age; Ig MP-DNA level; white blood cell, neutrophil (N), and monocyte counts; platelet (PLT), C-reactive protein (CRP), lactate dehydrogenase (LDH), triglycerides, high-density lipoprotein (HDL), low-density lipoprotein, and procalcitonin levels; and levels of T cells, CD4⁺ T cells, CD8⁺ T cells, B cells, and NK cells. The chi-square test was used to analyze differences in these variables between genders. One-way analysis of variance was used to select significant variables (P < 0.1) from the abovementioned ones, and the selected variables were analyzed by multivariate analysis of variance to detect independent risk factors. The receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) value were determined for the independent risk factors.

Results: The two groups showed significant differences in the levels of Ig MP-DNA, N, PLT, CRP, LDH, HDL, CD8⁺ T cells, and NK cells. PLT and Ig MP-DNA levels were positively correlated with the risk of SMPP development; however, HDL and NK levels showed a negative correlation. The AUC values for Ig MP-DNA + HDL, Ig MP-DNA + NK, Ig MP-DNA + PLT, NK + HDL, NK + PLT, and PLT + HDL were 0.825, 0.812, 0.813, 0.724, 0.717, and 0.701, respectively.

Conclusion: The combination of variables, including Ig MP-DNA + HDL, Ig MP-DNA + NK, and Ig MP-DNA + PLT, can predict whether MPP children would develop SMPP.

Aspergillus peyronelii is an emerging and rare pathogen causing chronic rhinosinusitis with fungal nasal polyposis among immunocompetent individuals. Usual fungal aetiologies are Aspergillus spp, Mucor spp and Cladosporium spp, among which Aspergillus flavus being the most common in India. We present a case of 28-year-old woman with unilateral nasal obstruction with 15 years history of allergy, diagnosed as nasal polyposis, uncovered an uncommon pathogen A.peyronelii. Being a saprophytic and endophytic fungus, meticulously diagnostic approaches were employed for the precise identification. Further researches are needed to optimize diagnostic strategies and therapeutic intervention of this species.

Purpose: Infections caused by rapidly growing mycobacteria (RGM) are increasing worldwide. The study was conducted in a microbiological laboratory of Bangladesh to determine the pattern of detection of RGM from clinical samples.

Methods: All laboratory culture records of RGM from 2012 to 2022 were collected retrospectively and analyzed.

Results: A total 62 RGM infected patients with surgical site infection (74.1 %), injection site and skin abscess (9.7 %), septicaemia (4.8 %) and UTI (1.6 %) were identified. The annual isolation frequency of RGM increased 4.8 %-29.1 % in between year 2012 and 2022. RGM infected patients (14.5 %) were mistakenly treated with first line anti tubercular drug before correct microbiological diagnosis (median, IQR; 3, 2-5 months). Out of 23 RGM isolates, 86.9 % were M. abscessus and rest 13.1 % were M. fortuitum. Most of them (≥95 %) were sensitive to amikacin, linezolid, clarithromycin where as 27.1 % to imipenem and ciprofloxacin, 40 % to cefoxitin, 35.3 % and 1.7 % to doxycycline and co-trimoxazole respectively.

Conclusion: Misdiagnosis or delay in diagnosis and erroneous treatment with first line anti tubercular drug may cause prolong morbidity and therapeutic failure to patients with RGM infection. So, early and appropriate diagnosis is crucial for successful outcome.