Indian Journal of Medical Microbiology最新文献_第2页

Immunological signatures and genomic adaptations in Human Mpox Clade Ib and IIb and Buffalopox Infections in India 印度人Mpox Ib和IIb和水痘感染的免疫学特征和基因组适应性。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-24 DOI: 10.1016/j.ijmmb.2026.101068

Deepak Y. Patil , Rima R. Sahay , Anita M. Shete , Shubin Chenayil , Nandan Mohite , Harsha C. Palav , Juhi Khurana , Vainav Patel , Pragya D. Yadav

Background

Mpox and buffalopox are zoonotic viral infections which demonstrate distinct clinical and immune profile. This study examines the clinical presentation with genomic and immunological characteristics among three confirmed cases of Mpox Clade IIb-A.2.1 and Clade Ib infections and a buffalopox from Malappuram, Kerala, India.

Methods

Immunophenotyping via flow cytometry was used to assess T, B, Natural Killer (NK) cells, and monocytes. The viral DNA, Anti-Mpox IgG/IgM, and anti-BPXV IgG were detected using real time PCR and ELISA respectively. Genomic characterization was performed using next generation sequencing. MAFFT alignment and IQ-TREE2 with maximum likelihood method was used for phylogenetic analysis.

Results

Clinically, vesiculo-pustular lesions detected in Mpoxv infection were more severe in Clade Ib patient along with penile edema and gangrenous eschar. The face and hands were primarily affected in BPXV infection. Immunological analysis demonstrated notable differences where Mpoxv infection exhibited major increase in lymphocytes and NK cells and differential activation patterns of immune T-cell population. During BPXV infection, B-cell numbers rose with expansion of mucosal-homing B-cells. IgM and IgG responses differed among infections, where Mpoxv Clade Ib generated early but transient IgM and low IgG titer, while Clade IIb-A.2.1 and BPXV exhibited prolonged IgG response. Genomic analysis revealed deletion in diagnostic region in Clade Ib, albeit Clade IIb showed host-derived mutations. The multiple genomic alignments revealed distinct immunological responses and vaccine development capacity of orthopoxviruses.

Conclusion

The findings of the study emphasizes the need for extensive genomic surveillance and immunological research. This will help in understanding the pattern of virus evolution and host immune responses in orthopoxvirus infections.

背景：水痘和水痘是人畜共患病毒感染，表现出不同的临床和免疫特征。本研究调查了来自印度喀拉拉邦马拉普兰的3例确诊Mpox Clade IIb-A.2.1和Clade Ib感染病例和1例水牛痘的临床表现、基因组学和免疫学特征。方法：采用流式细胞术进行T、B、NK细胞和单核细胞的免疫分型。采用real - time PCR和ELISA分别检测病毒DNA、抗m痘IgG/IgM和抗bpxv IgG。使用下一代测序进行基因组鉴定。采用MAFFT比对和IQ-TREE2最大似然法进行系统发育分析。结果：在临床上，Mpoxv感染的Clade Ib患者的膀胱脓疱病变更为严重，并伴有阴茎水肿和坏疽性结痂。BPXV感染以面部和手部为主。免疫分析显示，Mpoxv感染的淋巴细胞和NK细胞显著增加，免疫t细胞群的激活模式也有所不同。在BPXV感染期间，b细胞数量随着粘膜归巢b细胞的扩增而增加。不同感染对IgM和IgG的反应不同，其中Mpoxv Clade Ib产生早期但短暂的IgM和低IgG滴度，而Clade IIb-A.2.1和BPXV表现出长期的IgG滴度。基因组分析显示，在进化枝Ib的诊断区有缺失，尽管进化枝IIb表现出宿主衍生的突变。多个基因组比对揭示了正痘病毒不同的免疫应答和疫苗开发能力。结论：研究结果强调了广泛的基因组监测和免疫学研究的必要性。这将有助于理解正痘病毒感染的病毒进化模式和宿主免疫反应。

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引用次数: 0

Risk factors and outcome associated with the acquisition of colistin-resistant Klebsiella pneumoniae: A matched case-control-control study. 与获得耐粘菌素肺炎克雷伯菌相关的危险因素和结果：一项匹配的病例-对照研究

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-22 DOI: 10.1016/j.ijmmb.2026.101052

Prakash Shastri, Yamuna Devi Bakthavatchalam, Vijit Jaiswal, Chand Wattal, Balaji Veeraraghavan

Introduction: Carbapenem resistance in Klebsiella pneumoniae (Kp) has led to increased use of colistin-based therapy in the intensive care units (ICUs). Lately however, colistin resistance among K. pneumoniae has been widely reported. This study aims to investigate the prevalence, and the potential risk factors associated with colistin resistant K. pneumoniae (ColRKp) in the intensive care unit (ICU).

Materials and methods: All ICU patients, above 18 years of age, with a culture positive blood stream infection were included. A case-control-control design was used. Patients with colistin resistant K. pneumoniae (ColRKp) blood stream infections (BSI) were defined as cases. These were compared to two control populations, Control Group A had Kp infections moderately sensitive to colistin (ColMSKp); and control group B who had other bacterial infections. 50 ColRKp isolates were subjected to whole genome sequencing (WGS).

Results: Lungs as the source of infection (13.9 % vs 6.4 %, p ≤ 0.05) and longer hospital stay (26 days vs 22 days, p ≤ 0.05) were the significant risk factors which correlated with acquisition of colistin resistance in Klebsiella pneumoniae. An increased 28-day mortality was noticed in control groups who were given colistin based upon their in vitro sensitivity, (group A, 79 % and group B, 75.8 %) compared to cases (56.9 %). From among the ColRKp isolates subjected to WGS, 72 % (n = 36) carried NDM with OXA-48 like (OXA-181/232) carbapenemases. Mutations were found in pmrA, in pmrB, pmrC and pmrABC gene. None of the isolates had insertion in mgrB gene, all isolates were negative for mcr gene variants.

Conclusions: Both NDM and OXA-48 like carbapenemases were present in ColRKp. Patients receiving colistin therapy based on their in vitro sensitivity had increased risk for developing resistance to colistin and 28-day mortality.

肺炎克雷伯菌（Kp）的碳青霉烯耐药性导致重症监护病房（icu）中以粘菌素为基础的治疗的使用增加。然而最近，肺炎克雷伯菌的粘菌素耐药性已被广泛报道。本研究旨在调查重症监护病房（ICU）耐粘菌素肺炎克雷伯菌（ColRKp）的患病率及潜在危险因素。材料与方法：所有ICU患者，年龄大于18岁，培养阳性血流感染。采用病例-对照-对照设计。耐粘菌素肺炎克雷伯菌（ColRKp）血流感染（BSI）患者定义为病例。与两个对照人群进行比较，对照组A对粘菌素（ColMSKp）中度敏感的Kp感染；对照组B有其他细菌感染。对50株ColRKp进行全基因组测序（WGS）。结果：肺部为感染源（13.9% vs 6.4%, p≤0.05）和住院时间较长（26 d vs 22 d, p≤0.05）是肺炎克雷伯菌获得粘菌素耐药的重要危险因素。根据体外敏感性给予粘菌素的对照组28天死亡率（A组为79%，B组为75.8%）高于病例（56.9%）。在WGS作用的ColRKp分离株中，72% （n=36）携带具有OXA-48样（OXA-181/232）碳青霉烯酶的NDM。pmrA、pmrB、pmrC和pmrABC基因均发生突变。所有分离株均未插入mgrB基因，mcr基因变异均为阴性。结论：ColRKp中存在NDM和OXA-48样碳青霉烯酶。根据体外敏感性接受粘菌素治疗的患者对粘菌素产生耐药性和28天死亡率的风险增加。

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引用次数: 0

Molecular profiling of virulence determinants and antimicrobial resistance in MRSA isolates from HIV-infected and non-HIV individuals 来自hiv感染和非hiv个体的MRSA分离株的毒力决定因素和抗微生物药物耐药性的分子分析。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-22 DOI: 10.1016/j.ijmmb.2026.101064

Marimuthu Ragavan Rameshkumar , Ramachandran Vignesh , Pachamuthu Balakrishnan , Narasingam Arunagirinathan

Background

Staphylococcus aureus is an important pathogen exhibiting antibiotic resistance and multiple virulence factors. This study analyses the antimicrobial resistance and virulence genes of Staphylococcus aureus isolates from HIV and non-HIV patients from southern India.

Methods

S. aureus strains from HIV (n = 125) and non-HIV (n = 100) patients were isolated using conventional bacterial culture techniques. Antimicrobial resistance and virulence genes were analysed using polymerase chain reaction (PCR).

Results

Methicillin resistance was detected in 88.8 % and 34 % of the S. aureus isolates from HIV and non-HIV patients, respectively, and all tested positive for the mecA gene. SCCmec type V was the most frequently detected SCCmec cassette in MRSA from both HIV (55.2%) and non-HIV patients (44.4 %). MRSA isolates from HIV patients were 98.2 % positive for the penicillin resistance gene blaZ, followed by the aminoglycoside resistance genes aacA-aphD (82 %), aac(6′)/aph(2″) (75.7 %) and aph(3″)-IIIa (51.4 %), the tetracycline resistance genes tet(K) (42.3 %) and tet(M) (13.5 %) and the erythromycin resistance genes erm(C) (55 %). Among the non-HIV-infected MRSA strains, 73.5 % were positive for blaZ, followed by aac(6’)/aph(2″) (50 %), aacA-aphD (47.1 %), aph(3”)-IIIa (23.5 %), and erm(C) (29.4 %). The seb (7.2 %), sea (5.4 %), seb and sed (2.7 %), exfoliative toxin gene eta (3.6 %) and toxic shock syndrome toxin gene tst (8.1 %) were detected among MRSA from HIV patients, and the sea (5.9 %), sec (5.9 %), eta (5.9 %) and tst (8.8 %) were found among MRSA from non-HIV patients.

Conclusions

HIV patients are at a relatively greater risk of acquiring virulent and multidrug-resistant methicillin-resistant S. aureus infections than non-HIV patients.

背景：金黄色葡萄球菌是一种重要的病原菌，具有抗生素耐药和多种毒力因子。本研究分析了来自印度南部HIV患者和非HIV患者的金黄色葡萄球菌的耐药性和毒力基因。方法：采用常规细菌培养技术分离HIV患者（125株）和非HIV患者（100株）的金黄色葡萄球菌。采用聚合酶链式反应（PCR）对其耐药性和毒力基因进行分析。结果：从HIV和非HIV患者分离的金黄色葡萄球菌对甲氧西林的耐药率分别为88.8%和34%，mecA基因检测均为阳性。SCCmec V型（42.3%）是HIV患者MRSA中检出最多的SCCmec卡带，SCCmec II型（44.1%）是非HIV患者MRSA中检出最多的SCCmec卡带。HIV患者MRSA分离株中青霉素耐药基因blaZ阳性98.2%，其次是氨基糖苷类耐药基因aacA-aphD（82%）、aac（6′）/aph（2”）（75.7%）和aph（3”）-IIIa（51.4%）、四环素类耐药基因tet(K)（42.3%）和tet(M)（13.5%）和红霉素类耐药基因erm(C)（55%）。在非hiv感染的MRSA菌株中，blaZ阳性占73.5%，其次是aac（6’）/aph（2’）（50%）、aacA-aphD（47.1%）、aph（3’）-IIIa（23.5%）和erm(C)（29.4%）。HIV患者MRSA中检出seb（7.2%）、sea（5.4%）、seb和sed（2.7%）、剥脱性毒素基因eta（3.6%）和中毒性休克综合征毒素基因tst(8.1%)，非HIV患者MRSA中检出sea（5.9%）、sec（5.9%）、eta（5.9%）和tst（8.8%）。结论：与非HIV患者相比，HIV患者获得耐多药耐甲氧西林金黄色葡萄球菌感染的风险相对较大。

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引用次数: 0

Diagnostic accuracy of urinary lipoarabinomannan antigen detection for the diagnosis of pulmonary and extra pulmonary tuberculosis (EPTB) in HIV negative population 尿脂arabinman聚糖抗原检测对HIV阴性人群肺结核和肺外结核（EPTB）诊断的准确性

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-22 DOI: 10.1016/j.ijmmb.2026.101053

Kiran Bala , Rekha Rathee , Prayas Sethi , Praveen Bharti , Bhavuk Garg , Anant Mohan , Urvashi B. Singh

Background

Urine antigen testing seems promising tool to detect tuberculosis but data is scarce for pulmonary and extrapulmonary tuberculosis in HIV negative population.

Aims

This prospective cross-sectional study was designed to assess the urinary lipoarabinomannan antigen (LAM) diagnostic accuracy of pulmonary and extrapulmonary tuberculosis in HIV negative population.

Materials & methods

Suspected pulmonary (PTB) and extrapulmonary tuberculosis (EPTB) patients were enrolled and samples were subjected to routine diagnostic modalities. Urine samples were subjected to LAM test using lateral flow assay of Abbott TB LAM & results were statistically evaluated to gold standard culture, microbiological reference standards (MRS).

Results

Total 224 patients of suspected tuberculosis were enrolled in the study (23.21 % PTB and 76.79 % EPTB). Microbiologically confirmed tuberculosis was detected in 44 (19.6 %), PTB (48.0 %) & EPTB (11.0 %) cases. Mycobacterium tuberculosis was detected in ZN stain (16.5 %), MGIT liquid culture (14.7 %), Gene-Xpert MTB/Rif (17.4 %), urinary LAM (22.7 %). Sensitivity, specificity, PPV and NPV of urine LAM against the gold standard test (MGIT) were 60.61 %, 83.77 %, 39.22 %, 92.49 %; and as per the MRS criteria these values were 48.0 %, 84.5 %, 47.1 %, 85.0 % respectively. Among smear positive samples sensitivity, specificity, PPV, NPV of LAM were 65.5 %, 50.0 %, 82.6 %, 28.6 % respectively.

Conclusion

Urine LAM performed better than previously reported in HIV-negative populations but remains suboptimal as a point-of-care test. This study showed higher sensitivity and PPV for pulmonary TB in MRS smear-positive cases, better specificity and NPV for extrapulmonary TB, good performance in smear-negative extrapulmonary TB, and promising utility in unconfirmed TB.

背景：在HIV阴性人群中，尿液抗原检测似乎是一种很有前途的检测结核病的工具，但关于肺结核和肺外结核的数据很少。目的：本前瞻性横断研究旨在评估尿脂阿拉伯糖甘露聚糖抗原（LAM）对HIV阴性人群肺结核和肺外结核的诊断准确性。材料与方法对疑似肺结核（PTB）和肺外结核（EPTB）患者进行常规诊断。尿液样本采用雅培TB LAM横向流动法进行LAM检测，结果统计评估为金标准培养，微生物参考标准（MRS）。结果共纳入疑似结核患者224例，其中肺结核占23.21%，EPTB占76.79%。微生物学确诊结核44例（19.6%），肺结核（48.0%）和EPTB（11.0%）。ZN染色检出结核分枝杆菌（16.5%），MGIT液体培养（14.7%），Gene-Xpert MTB/Rif(17.4%)，尿LAM（22.7%）检出结核分枝杆菌。尿液LAM对金标准试验（MGIT）的敏感性、特异性、PPV和NPV分别为60.61%、83.77%、39.22%、92.49%；按MRS标准分别为48.0%、84.5%、47.1%、85.0%。在涂片阳性样本中，LAM的敏感性为65.5%，特异性为50.0%，PPV为82.6%，NPV为28.6%。结论尿液LAM在hiv阴性人群中的表现比之前报道的要好，但作为一种即时检测方法仍然不够理想。该研究显示，MRS涂片阳性病例对肺结核具有更高的敏感性和PPV，对肺外结核具有更好的特异性和NPV，对涂片阴性的肺外结核具有良好的疗效，对未确诊结核病具有良好的应用前景。

{"title":"Diagnostic accuracy of urinary lipoarabinomannan antigen detection for the diagnosis of pulmonary and extra pulmonary tuberculosis (EPTB) in HIV negative population","authors":"Kiran Bala , Rekha Rathee , Prayas Sethi , Praveen Bharti , Bhavuk Garg , Anant Mohan , Urvashi B. Singh","doi":"10.1016/j.ijmmb.2026.101053","DOIUrl":"10.1016/j.ijmmb.2026.101053","url":null,"abstract":"<div><h3>Background</h3><div>Urine antigen testing seems promising tool to detect tuberculosis but data is scarce for pulmonary and extrapulmonary tuberculosis in HIV negative population.</div></div><div><h3>Aims</h3><div>This prospective cross-sectional study was designed to assess the urinary lipoarabinomannan antigen (LAM) diagnostic accuracy of pulmonary and extrapulmonary tuberculosis in HIV negative population.</div></div><div><h3>Materials & methods</h3><div>Suspected pulmonary (PTB) and extrapulmonary tuberculosis (EPTB) patients were enrolled and samples were subjected to routine diagnostic modalities. Urine samples were subjected to LAM test using lateral flow assay of Abbott TB LAM & results were statistically evaluated to gold standard culture, microbiological reference standards (MRS).</div></div><div><h3>Results</h3><div>Total 224 patients of suspected tuberculosis were enrolled in the study (23.21 % PTB and 76.79 % EPTB). Microbiologically confirmed tuberculosis was detected in 44 (19.6 %), PTB (48.0 %) & EPTB (11.0 %) cases. <em>Mycobacterium tuberculosis</em> was detected in ZN stain (16.5 %), MGIT liquid culture (14.7 %), Gene-Xpert MTB/Rif (17.4 %), urinary LAM (22.7 %). Sensitivity, specificity, PPV and NPV of urine LAM against the gold standard test (MGIT) were 60.61 %, 83.77 %, 39.22 %, 92.49 %; and as per the MRS criteria these values were 48.0 %, 84.5 %, 47.1 %, 85.0 % respectively. Among smear positive samples sensitivity, specificity, PPV, NPV of LAM were 65.5 %, 50.0 %, 82.6 %, 28.6 % respectively.</div></div><div><h3>Conclusion</h3><div>Urine LAM performed better than previously reported in HIV-negative populations but remains suboptimal as a point-of-care test. This study showed higher sensitivity and PPV for pulmonary TB in MRS smear-positive cases, better specificity and NPV for extrapulmonary TB, good performance in smear-negative extrapulmonary TB, and promising utility in unconfirmed TB.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"60 ","pages":"Article 101053"},"PeriodicalIF":1.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Candidozyma auris: Identification, antifungal susceptibility, and caspofungin-induced paradoxical growth. 耳念珠菌：鉴定，抗真菌敏感性和卡泊霉素诱导的矛盾生长。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-21 DOI: 10.1016/j.ijmmb.2026.101065

Gülşah Ece Özmerdiven, Arzu İrvem

Purpose: The aim of this study is to evaluate the effectiveness of VITEK®2 and CHROMagar™ Candida Plus agar in the identification of C. auris, using MALDI-TOF MS results as the reference standard. Additionally, to assess antifungal susceptibility, the study compares the results of two widely used commercial methods in routine laboratory practice: VITEK®2 and Sensititre™ YeastOne™ (SYO).

Methods: A total of 63 C. auris isolates were included in the study. VITEK®2 results were evaluated in comparison to SYO, and categorical agreement, major error (ME), and very major error (VME) rates were calculated. MIC50, MIC90 values and resistance rates determined by both methods were compared. The Eagle effect was also investigated.

Results: The VITEK®2 results (74 %) and the morphological characteristics of colonies grown on CHROMagar™ Candida Plus (100 %) were found to be consistent with MALDI-TOF MS identification. In the SYO method, the MIC values for amphotericin B, fluconazole, and voriconazole were found to be higher compared to those obtained by VITEK®2. No resistance was detected against micafungin and anidulafungin. Resistance observed in relation to caspofungin MIC values was identified as the Eagle effect. MIC50 and MIC90 values determined by VITEK®2 were lower than those obtained by SYO, except for amphotericin B, for which VITEK®2 showed a higher MIC90 value.

Conclusion: In our study, it was observed that CHROMagar™ Candida Plus can be used as a screening method for the identification of C. auris in hospitals without access to MALDI-TOF MS. Incompatibility was detected in antifungal susceptibility testing, and the rates of major error (ME) and very major error (VME) were found to be high. For caspofungin, the high dilution range in the SYO method was determined which also detected the Eagle effect.

目的：以MALDI-TOF质谱结果为对照标准，评价VITEK®2和CHROMagar™Candida Plus琼脂对金黄色葡萄球菌（C. auris）的鉴定效果。此外，为了评估抗真菌敏感性，该研究比较了常规实验室实践中两种广泛使用的商业方法的结果：VITEK®2和Sensititre™YeastOne™（SYO）。方法：对63株金黄色葡萄球菌进行研究。将VITEK®2结果与SYO进行比较评估，并计算绝对一致性、严重错误（ME）和非常严重错误（VME）率。比较两种方法测定的MIC50、MIC90值及电阻率。鹰效应也被研究过。结果：VITEK®2检测结果（74%）和CHROMagar™念珠菌Plus菌落形态特征（100%）与MALDI-TOF MS鉴定结果一致。在SYO方法中，两性霉素B、氟康唑和伏立康唑的MIC值比VITEK®2获得的MIC值更高。对米卡芬宁和阿尼杜拉芬宁均未发现耐药性。观察到的与caspofungin MIC值相关的抗性被确定为Eagle效应。VITEK®2测定的MIC50和MIC90值低于SYO测定的MIC50和MIC90值，但两性霉素B的MIC90值较高。结论：本研究发现，CHROMagar™Candida Plus可作为一种筛选方法，用于在无法获得MALDI-TOF ms的医院中鉴定金黄色葡萄球菌。在抗真菌药敏试验中发现不相容，且严重错误（ME）和非常严重错误（VME）率较高。对于caspofunins，确定了SYO法的高稀释范围，也检测到了Eagle效应。

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引用次数: 0

Antimicrobial activity of native Lactobacillus cell-free supernatant against diarrheagenic Escherichia coli isolated from hospitalized patients in northern Iran 原生无细胞乳酸杆菌上清液对伊朗北部住院患者分离的致泻性大肠杆菌的抑菌活性

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-20 DOI: 10.1016/j.ijmmb.2026.101063

Farzaneh Rafie Sedaghat , Ali Mojtahedi , Meysam Hasannejad-Bibalan , Tofigh Yaghubi Kalurazi , Tohid Samadpour Zahmat-dar

Background and aims

Antibiotic resistance is a growing concern in the fight against Escherichia coli, a pathogen that causes various intestinal diseases. The present study explores the antibacterial effect of lactobacillus on E. coli pathotypes.

Methods

Inpatients stool samples were collected and E. coli pathotypes were identified. The antibacterial effect of five Lactobacillus on the pathotypes was investigated by broth microdilution and well diffusion methods.

Results

The CFS of L. plantarum, L. rueteri and L. acidophilus had the greatest antibacterial effect.

Conclusion

Postbiotics have shown significant bactericidal effects against E. coli pathotypes. Their bactericidal effect can prevent the colonization of these pathotypes in hospitalized patients.

背景和目的：抗生素耐药性是对抗大肠杆菌的一个日益关注的问题，大肠杆菌是一种引起多种肠道疾病的病原体。本研究探讨乳酸菌对大肠杆菌病原菌的抑菌作用。方法：收集住院患者粪便标本，鉴定大肠杆菌病原。采用微量肉汤稀释法和孔扩散法研究了5种乳酸菌对病原菌的抑菌作用。结果：植物乳杆菌、鲁氏乳杆菌和嗜酸乳杆菌的CFS抑菌效果最好。结论：益生后制剂对大肠杆菌病原菌有明显的杀菌作用。它们的杀菌作用可以阻止这些病原菌在住院病人体内的定植。

引用次数: 0

“In vitro evaluation of sulbactam combination therapies for Acinetobacter baumannii” 舒巴坦联合治疗鲍曼不动杆菌的体外评价。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-16 DOI: 10.1016/j.ijmmb.2026.101051

Karthick Kumar Vaitheeswaran , Seema Sood , Manish Soneja , Animesh Ray , Shivam Pandey , Arti Kapil , Naveet Wig

Background and objectives

Acinetobacter baumannii, a leading cause of hospital-acquired infections in critically ill patients, is increasingly resistant to carbapenems, leading WHO to designate carbapenem-resistant Acinetobacter baumannii (CRAB) as a critical priority pathogen. While the 2024 IDSA guidelines recommend sulbactam-based regimens as the cornerstone of therapy, high-dose sulbactam is effective only against isolates with MICs up to 16–32 μg/mL. This study aimed to describe the sulbactam MIC distribution and to evaluate MIC reduction and synergy when combined with β-lactam antibiotics against CRAB.

Methods

CRAB isolates from respiratory samples of ventilator-associated pneumonia patients were tested using E-tests to determine MICs of individual antibiotics. Combinations of sulbactam with ceftriaxone, cefepime, and meropenem were assessed using the E-test cross method. Synergy was evaluated by the FIC index: synergy (≤0.5), additive (>0.5–1), indifference (>1–<4), and antagonism (≥4).

Results

Thirty-five non-duplicate CRAB isolates were tested. All isolates were resistant to ceftriaxone, cefepime, and meropenem when tested individually, with MICs exceeding E-test detection limits. Hence, although sulbactam combinations significantly reduced MICs, the resulting values often remained above CLSI-defined susceptibility breakpoints.

Notably, sulbactam alone showed an MIC₅₀ of 12 μg/mL and an MIC₉₀ of 24 μg/mL. In combination, sulbactam MIC₅₀/MIC₉₀ values were reduced to 8/24 μg/mL with ceftriaxone, 6/16 μg/mL with cefepime, and 8/24 μg/mL with meropenem.

Sulbactam–cefepime showed the highest synergy (11.43 %) and additive effects (34.29 %), followed by sulbactam–ceftriaxone (2.86 % synergy; 31.43 % additive). Sulbactam–meropenem showed no synergy but 31.43 % additive effects. No antagonism was observed with any combination.

Conclusion

Combining sulbactam with β-lactams, particularly cefepime, significantly reduced sulbactam MICs. However, the β-lactam MICs themselves remained largely within not-susceptible ranges, highlighting that the observed benefit was confined primarily to sulbactam rather than the companion β-lactams. These findings supported further clinical studies of high-dose sulbactam–β-lactam combinations to optimize the pharmacodynamic efficacy of sulbactam against CRAB strains with elevated MICs.

背景和目的：鲍曼不动杆菌（Acinetobacter baumannii）是危重患者医院获得性感染的主要原因，对碳青霉烯类药物的耐药性日益增强，这使得世卫组织将耐碳青霉烯类鲍曼不动杆菌（Acinetobacter baumannii， CRAB）指定为一种重要的优先病原体。虽然2024年IDSA指南推荐以舒巴坦为基础的方案作为治疗的基础，但大剂量舒巴坦仅对mic高达16-32 μg/mL的分离株有效。本研究旨在描述舒巴坦的MIC分布，并评估与β-内酰胺类抗生素联合治疗螃蟹时的MIC降低和协同作用。方法：采用e -test检测呼吸机相关性肺炎患者呼吸道样本中分离的CRAB菌株，测定抗生素的mic。舒巴坦与头孢曲松、头孢吡肟和美罗培南的联合应用采用e检验交叉法进行评估。采用FIC指数评价协同效应：协同效应（≤0.5）、加性（>0.5-1）、无差异（>1- 1）。所有分离株在单独检测时均对头孢曲松、头孢吡肟和美罗培南耐药，mic均超过E-test检测限。因此，尽管舒巴坦联合用药可显著降低mic，但结果值通常仍高于clsi定义的敏感性断点。单药舒巴坦的MIC50为12 μg/mL， MIC90为24 μg/mL。与头孢曲松联合用药后，舒巴坦MIC50/MIC90值降至8/24 μg/mL，与头孢吡肟联合用药后降至6/16 μg/mL，与美罗培南联合用药后降至8/24 μg/mL。舒巴坦-头孢吡肟的协同效应最高（11.43%），叠加效应最高（34.29%），舒巴坦-头孢曲松次之（协同效应2.86%，叠加效应31.43%）。舒巴坦与美罗培南无协同效应，但有31.43%的叠加效应。任何联合用药均未见拮抗作用。结论：舒巴坦与β-内酰胺类药物，尤其是头孢吡肟合用可显著降低舒巴坦的mic。然而，β-内酰胺类MICs本身在很大程度上仍处于不敏感范围，这表明观察到的益处主要局限于舒巴坦，而不是伴随的β-内酰胺类药物。这些发现为进一步开展高剂量舒巴坦-β-内酰胺联合用药的临床研究提供了支持，以优化舒巴坦对mic升高的螃蟹菌株的药效学疗效。

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引用次数: 0

Unveiling the microbiological experience in exploring spinal TB cases from a tertiary care center 揭示微生物的经验，探索脊柱结核病例从三级保健中心。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-16 DOI: 10.1016/j.ijmmb.2026.101050

Jaya Biswas , Kiran Bala , Neha Nityadarshini , Leander Jose , Vivek Shankar , Urvashi B. Singh

Purpose

Spinal tuberculosis, a severe form of extrapulmonary tuberculosis, poses significant diagnostic and therapeutic challenges, often leading to neurological complications and deformity. Microbiological confirmation is crucial for diagnosis and effective treatment. We aim to evaluate the microbiological profile and diagnostic yield of various methods in spinal TB cases at a tertiary care centre and to correlate with clinical features and treatment outcomes.

Methods

A prospective study was conducted on samples from patients with suspected spinal TB (n = 58) from July 2023 to September 2024. All samples were processed using Ziehl-Neelsen (ZN) staining for acid-fast bacilli (AFB), culture on Lowenstein-Jensen (LJ) medium, BACTEC MGIT 960 liquid culture system, and GeneXpert MTB/RIF assay for rapid detection of MTB and rifampicin sensitivity. Relevant demographic, clinical, and radiological data were collected and analyzed. Based on susceptibility to drugs of culture isolates, treatment was started to see the outcome, and follow-ups were done with the patients.

Results

A total of 19 spinal TB cases were microbiologically confirmed, out of 58 clinically suspected spinal TB cases, with a male predominance (57.9 %) and age range of 13–72 years. The most common symptom was lower back pain (89.5 %). GeneXpert was positive in all cases, detecting rifampicin resistance in 7(36.8 %). Culture was positive in 11 cases. ZN staining was positive in 15.8 % of direct samples. Histopathology showed granulomatous inflammation in 9 (47.3 %) of cases. MRI confirmed infective spinal involvement in 17(89.5 %) patients. MDR-TB regimen was initiated in 7 patients. Overall recovery was good, except one case of neuropathy and one mortality.

Conclusions

A combination of smear microscopy, culture, and molecular diagnostics significantly improves the microbiological diagnosis of spinal TB. GeneXpert offers rapid, reliable results, especially in rifampicin resistance detection. Early and accurate microbiological confirmation, coupled with clinical-radiological correlation, is essential for effective management and improved patient outcomes.

目的：脊柱结核是肺外结核的一种严重形式，对诊断和治疗提出了重大挑战，通常导致神经系统并发症和畸形。微生物学确认对诊断和有效治疗至关重要。我们的目的是评估在三级保健中心的脊柱结核病例中各种方法的微生物谱和诊断产量，并与临床特征和治疗结果相关联。方法：对2023年7月至2024年9月期间疑似脊柱结核患者（n=58）进行前瞻性研究。所有样品均采用Ziehl-Neelsen （ZN）染色法检测抗酸杆菌（AFB）， Lowenstein-Jensen （LJ）培养基培养，BACTEC MGIT 960液体培养系统，GeneXpert MTB/RIF法快速检测MTB和利福平敏感性。收集并分析了相关的人口学、临床和放射学资料。根据培养分离菌对药物的敏感性，开始治疗，并对患者进行随访。结果：58例脊柱结核临床疑似病例中，微生物学确诊19例，男性居多（57.9%），年龄13 ~ 72岁。最常见的症状是腰痛（89.5%）。GeneXpert检测结果均为阳性，其中7例（36.8%）检测出利福平耐药。11例培养阳性。15.8%的直接样品ZN染色阳性。组织病理学检查显示肉芽肿性炎症9例（47.3%）。MRI证实17例（89.5%）患者有感染性脊柱受累。7名患者开始了耐多药结核病治疗方案。除1例神经病变和1例死亡外，整体恢复良好。结论：涂片镜检、培养和分子诊断相结合可显著提高脊柱结核的微生物学诊断。GeneXpert提供快速、可靠的结果，特别是在利福平耐药性检测方面。早期和准确的微生物学确认，加上临床-放射学相关性，对于有效管理和改善患者预后至关重要。

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引用次数: 0

A rising threat: Emergence of Listeria monocytogenes infection from hilly terrain of North India 日益上升的威胁：印度北部丘陵地带出现单核细胞增生李斯特菌感染。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-13 DOI: 10.1016/j.ijmmb.2026.101048

Pratiksha Kamboj, Vanya Singh, Priyal Anand, Balram Ji Omar

Listeria monocytogenes is a foodborne pathogen capable of causing severe invasive infections, particularly meningitis, in neonates, immunocompromised individuals, and pregnant women. This report represents a neonate with multiple complications including meningitis. This case underscores the diagnostic difficulties and therapeutic challenges posed by L. monocytogenes, especially in high-risk populations. Early recognition, timely antimicrobial therapy, and close long-term follow-up are critical for improving outcomes in affected patients and minimizing the risk of neurological sequelae or fatal progression.

单核细胞增生李斯特菌是一种食源性病原体，能够在新生儿、免疫功能低下个体和孕妇中引起严重的侵袭性感染，特别是脑膜炎。本报告报告了一例新生儿多发性并发症，包括脑膜炎。该病例强调了单增李斯特菌的诊断困难和治疗挑战，特别是在高危人群中。早期识别、及时抗菌治疗和密切的长期随访对于改善受影响患者的预后和最大限度地减少神经系统后遗症或致命进展的风险至关重要。

引用次数: 0

Acute Abdominal Pain Attributable to Salmonella Typhi-Infected Endometriotic Cyst: A Rare Case Report. 斑疹伤寒沙门氏菌感染的子宫内膜异位囊肿引起急性腹痛：一例罕见病例报告。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-13 DOI: 10.1016/j.ijmmb.2026.101049

Priyam Batra, Kanika Chaudhary, Amarinder Singh Malhi, Megha Batra, Hitender Gautam, Sarita Mohapatra, Seema Sood, Benu Dhawan, Bimal Kumar Das

Endometriotic cyst infection is rare and typically associated with invasive pelvic procedures or pelvic inflammatory disease. We present a case of a 34-year-old nulligravida female with no recent surgical or gynaecological interventions, who developed acute abdominal pain due to a ruptured endometriotic cyst infected with Salmonella enterica serovar Typhi. This case underscores the potential for hematogenous spread of infection and the importance of considering infected endometriomas in the differential diagnosis of acute abdomen.

子宫内膜异位囊肿感染是罕见的，通常与侵入性盆腔手术或盆腔炎有关。我们报告一例34岁无孕女性，近期没有手术或妇科干预，因子宫内膜异位囊肿破裂感染伤寒沙门氏菌而出现急性腹痛。本病例强调了血液传播感染的可能性，以及在急腹症鉴别诊断中考虑感染子宫内膜瘤的重要性。

引用次数: 0