Indian Journal of Medical Microbiology最新文献_第3页

“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

Development of an enhanced LAMP-based method for early identification of Streptococcus pneumoniae through LytA gene amplification 基于lamp的LytA基因扩增肺炎链球菌早期鉴定方法的建立。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-10 DOI: 10.1016/j.ijmmb.2026.101047

Jignisha S. Patel , Jigna P. Naik , Dhruv N. Desai

Introduction

Streptococcus pneumoniae is a leading cause of invasive bacterial disease in developed and developing countries. The LytA gene acts as a key pneumococcal virulence factor. No simple, cost-effective technology exists to detect this gene. In this study, we developed and validated a quick and visible LAMP assay targeting the LytA gene for pneumococci detection.

Methodology

Visual LAMP assay was performed to amplify the S. pneumoniae LytA gene using five primers. S. pneumoniae ATCC® 49619™ was employed as a positive control, and 19 pathogenic bacterial strains without the LytA gene and 20 clinical isolates with the gene were utilized to test LAMP assay specificity. To assess sensitivity, the visual LAMP assay was compared to PCR using ten-fold serial dilutions of Pneumococcal ATCC DNA. The clinical sensitivity and specificity of the enhanced LAMP assay were tested with 25 pneumonia-suspected clinical samples. In addition, standard microbial culture and PCR analysis were also performed for comparison purposes.

Results

After 60 min of incubation at 65 °C, the S. pneumoniae ATCC strain and all 20 clinical pneumococci with defined primers amplified LytA target DNA and gave a color change from pink to yellow. DNA amplification was absent in 19 pathogenic bacterial strains without LytA genes under the same circumstances. The detection limit for the improved LAMP assay was 6 CFU/mL (0.425 fg/μL). Given conventional microbiological culture as the gold standard, the PCR assay provided two false positives, whereas the LAMP assay gave no false positives with 25 clinical samples. The LAMP assay exhibited 100 % sensitivity, specificity, PPV and NPV (95 % CI) utilizing the conventional culture method as a gold standard.

Conclusion

The enhanced LAMP assay visually detects the pneumococcal LytA gene faster, simpler, more sensitively, and more specifically than PCR and microbiological methods. This enhanced LAMP method is suited for low-resource population screening and diagnosis.

简介：肺炎链球菌是发达国家和发展中国家侵袭性细菌疾病的主要原因。LytA基因是一个关键的肺炎球菌毒力因子。目前还没有一种简单、经济的技术来检测这种基因。在这项研究中，我们开发并验证了一种针对LytA基因的快速可见LAMP检测方法，用于肺炎球菌的检测。方法：采用LAMP法，用5个引物扩增肺炎链球菌LytA基因。以肺炎链球菌ATCC®49619™为阳性对照，选取19株不含LytA基因的病原菌和20株含LytA基因的临床分离菌进行LAMP特异性检测。为了评估灵敏度，使用肺炎球菌ATCC DNA的10倍连续稀释，将目视LAMP试验与PCR进行比较。应用增强型LAMP检测方法对25例疑似肺炎临床标本进行临床敏感性和特异性检测。此外，还进行了标准微生物培养和PCR分析以进行比较。结果：在65℃下培养60分钟后，肺炎链球菌ATCC菌株和所有20种临床肺炎球菌均扩增出LytA靶DNA，颜色由粉红色变为黄色。在相同条件下，19株不含LytA基因的病原菌没有DNA扩增。改进LAMP法的检出限为6 CFU/mL （0.425 fg/μL）。以传统微生物培养为金标准，PCR检测出现2个假阳性，而LAMP检测在25个临床样本中没有出现假阳性。LAMP检测具有100%的灵敏度、特异性、PPV和NPV (95% CI)，以常规培养方法为金标准。结论：增强型LAMP法检测肺炎球菌LytA基因比PCR和微生物学方法更快、更简单、更敏感、更特异。这种增强型LAMP方法适用于低资源人群的筛查和诊断。

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引用次数: 0

Uncommon non-fermentative gram-negative superbugs - A surge in bacteraemia patients at an apex super speciality hospital 罕见的非发酵革兰氏阴性超级细菌-在Apex超级专科医院菌血症患者激增。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-09 DOI: 10.1016/j.ijmmb.2026.101046

Munaza Aman, Insha Altaf, Bashir A. Fomda, Shagufta Roohi, Anjum Mir, Sehar Tariq, Uksim Qadri

Background and objectives

Gram negative bacteria are most common cause of bacteraemia, with one fourth being attributed to non-fermentive Gram negative bacteria (NFGNB). Contribution of NFGNB to antimicrobial resistance burden is also high. Commonly isolated NFGNB Pseudomonas aeruginosa and Acinetobacter baumannii have been well studied however there is paucity of data of uncommon species including, Stenotrophomonas maltophilia, Burkholderia spp., Sphingomonas paucimobilis in our region. This study was thus designed to explore implication of antimicrobial resistance and associated determinants for the surge of such organisms.

Material and methods

Antimicrobial susceptibility profile of NFGNB isolates, recovered from flag positive blood culture bottles on BacT/ALERT3D system, identified by VITEK 2 compact system, over a period of one year at the department of Microbiology and risk factors associated with upsurge of common and uncommon NFGNB were also compared.

Results

A total of 133 NFGNB isolates were recovered from bacteraemia patients. Among common NFGNB, Acinetobacter baumannii (34.6 %) was commonest followed by Pseudomonas aeruginosa (15 %). While among uncommon NFGNB Acinetobacter non baumannii spp. of Acinetobacter baumannii complex were most prevalent (15 %) followed by Burkholderia cepacia complex (10.5 %) and Sphingomonas paucimobilis (8.2 %). Eighty percent of isolates were MDR and association of uncommon NFGNB surge was observed to be associated with risk factors like hospital acquired infection, recent broad spectrum antimicrobial exposure, primary bacteraemia and catheter related infection (p < 0.05).

Conclusion

Bacteraemia due to MDR NFGNB is an alarming therapeutic management challenge as empirical treatment is not effective especially for uncommon NFGNB.

背景和目的：革兰氏阴性菌是引起菌血症的最常见原因，其中四分之一归因于非发酵革兰氏阴性菌（NFGNB）。NFGNB对抗菌素耐药性负担的贡献也很高。常见的NFGNB铜绿假单胞菌和鲍曼不动杆菌已经得到了很好的研究，但在我们地区缺乏罕见物种的数据，包括嗜麦芽窄养单胞菌、伯克霍尔德氏菌、少动鞘单胞菌。因此，本研究旨在探讨抗菌素耐药性及其相关决定因素对此类生物激增的影响。材料与方法：采用VITEK 2紧凑型系统，对我院微生物科1年多时间内从BacT/ALERT3D系统检测阳性血培养瓶中分离得到的NFGNB菌株进行药敏分析，比较常见与不常见NFGNB爆发的相关危险因素。结果：从菌血症患者中共分离到133株NFGNB。常见NFGNB中以鲍曼不动杆菌（34.6%）最为常见，其次为铜绿假单胞菌（15%）。在不常见的NFGNB不动杆菌中，鲍曼不动杆菌复群以非鲍曼不动杆菌最为常见（15%），其次是洋葱伯克氏菌复群（10.5%）和少动鞘单胞菌（8.2%）。80%的分离株为耐多药，观察到罕见的NFGNB激增与医院获得性感染、近期广谱抗菌药物暴露、原发性菌血症和导管相关感染等危险因素相关(p结论：耐多药NFGNB引起的菌血症是一个令人震惊的治疗管理挑战，因为经验治疗尤其对罕见的NFGNB无效。

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引用次数: 0

Phaeoacremonium junior phaeohyphomycosis: A case report of the first human infection 少年褐孢霉病：首例人感染病例报告。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-09 DOI: 10.1016/j.ijmmb.2026.101043

G. Vithiya , M. Srividhya , T. Rajendran , Supriya Sahu , Diptanu Paul , Madhucchanda Das , Shivaprakash M. Rudramurthy , Vinaykumar Hallur

Phaeoacremonium junior is a rare dematiaceous fungus found in woody plants, grapevine, and fruit trees. We report the first case of human infection with Phaeoacremonium junior who presented with a subcutaneous cyst after a thorn prick. Identification was done by sequencing the partial beta-tubulin and partial actin genes and their multigene phylogeny.

Phaeoacremonium junior是一种罕见的木本植物真菌，存在于木本植物、葡萄藤和果树中。我们报告第一例人类感染的Phaeoacremonium junior谁提出了一个皮下囊肿后刺。通过对部分β -微管蛋白和部分肌动蛋白基因的测序及其多基因系统发育进行鉴定。

引用次数: 0

Invasive aspergillosis in a child without any identifiable risk factors 儿童侵袭性曲霉病无任何可识别的危险因素

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-09 DOI: 10.1016/j.ijmmb.2026.101045

Surbhi Kumari , Pallavi Pallavi , Virendra Kumar , Vagata Ram , Romit Saxena , Sonal Saxena , Meeta Singh

The diagnosis of invasive aspergillosis is difficult because its clinical presentation overlaps with other common diseases. This disease is rare in children without any risk factors. We share a case of a healthy young Asian boy who presented with persistent fever, generalized lymphadenopathy, and pericardial effusion. Given these symptoms, the initial suspicion leaned heavily towards tuberculosis (TB) or lymphoma. On further investigations, the unexpected diagnosis was made as his lymph node culture grew Aspergillus flavus. This case serves as an important reminder that invasive aspergillosis, although rare in children without traditional risk factors, can still present in the most surprising ways.

侵袭性曲霉病的诊断是困难的，因为它的临床表现与其他常见疾病重叠。这种疾病在没有任何危险因素的儿童中很少见。我们报告一个健康的亚洲男孩，表现为持续发热、全身淋巴结肿大及心包积液。鉴于这些症状，最初的怀疑很大程度上倾向于肺结核或淋巴瘤。在进一步的检查中，当他的淋巴结培养物生长出黄曲霉时，做出了意想不到的诊断。这一病例提醒我们，侵袭性曲霉病虽然在没有传统危险因素的儿童中很少见，但仍然可以以最令人惊讶的方式出现。

引用次数: 0

Revisiting clinicomycological and immunological aspects of fungal rhinosinusitis during COVID-19 pandemic 重新审视COVID-19大流行期间真菌性鼻窦炎的临床菌学和免疫学方面。

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ijmmb.2025.101036

Mohan Vashistha , Malini R. Capoor , Geetika Khanna , Anita Rani , Neena Chaudhary

Background and objectives

To determine the relation between disease spectrum, etiology and immunological markers in fungal rhinosinusitis (FRS).

Material and methods

Sinus and nasal tissue samples were collected by diagnostic nasal endoscopy and were processed as per standard mycological procedure for microscopy, culture and histopathological examination (HPE). Total IgE, serum IL-6, IL-10, TNF-α levels were detected by Enzyme linked immunosorbent assay.

Results

Out of 148 samples, 70 % were diagnosed as FRS. The most common comorbid condition was COVID-19 infection 46.9 %. The most common predisposing factor was use of steroid therapy 46.9 %. Nasal obstruction 62.2 % was the most common clinical feature but headache (p value 0.002) and eye discharge were statistically significant (p value 0.005). In this study Pottasium hydroxide (KOH) mount revealed findings in 84.69 % patients. KOH, Histopathological examination (HPE) and fungal culture in combination revealed findings in 62.2 % cases. Rhizopus arrhizus 27.6 % was the most common isolate Aspergillus flavus and Rhizopus arrhizus were statistically significant (p value 0.003, 0.026 respectively). In this study IL-6 59.2 % was the most common serological marker raised. Paranasal sinus (PNS) imaging revealed that 100 % of the patients had single or multiple sinus involvement and maxillary sinus (p value 0.038) was significantly associated. Acute invasive fungal rhinosinusitis 75.5 % was the most common type of FRS. In this study mortality was 17.34 %.

Conclusion

FRS is an important emerging public health problem and a cause of mortality and morbidity, particularly in immunocompromised patients. Furthermore, in the current scenario of the COVID pandemic, FRS has become more fatal and an entity of immediate and grave concern than ever before. Early identification in suspected cases with predisposing factors and early intervention is crucial for the outcome of FRS cases.

背景与目的：探讨真菌性鼻窦炎（FRS）的病谱、病因和免疫学指标之间的关系。材料与方法：诊断性鼻内窥镜采集鼻窦和鼻腔组织标本，按标准真菌学程序进行镜检、培养和组织病理学检查（HPE）。采用酶联免疫吸附法检测总IgE、血清IL-6、IL-10、TNF-α水平。结果：148份样本中，诊断为FRS的占70%，最常见的合并症为COVID-19感染，占46.9%。最常见的诱发因素是使用类固醇治疗（46.9%）。鼻塞为62.2%，头痛（p值0.002）和流涕（p值0.005）为最常见的临床特征。在本研究中，84.69%的患者发现氢氧化钾（KOH）支架。KOH、组织病理学检查（HPE）和真菌培养联合检查62.2%。黄曲霉和阿根霉最常见的分离物为27.6% （p值分别为0.003、0.026）。在本研究中，IL-6是最常见的血清标志物，升高率为59.2%。副鼻窦（PNS）影像学显示100%的患者有单一或多个鼻窦受累，上颌窦受累（p值0.038）显著相关。急性侵袭性真菌性鼻窦炎是最常见的FRS类型，占75.5%，死亡率为17.34%。结论：FRS是一个重要的新出现的公共卫生问题和死亡率和发病率的原因，特别是在免疫功能低下的患者。此外，在COVID大流行的当前情况下，FRS变得比以往任何时候都更加致命，并成为一个迫切和严重关切的实体。早期发现疑似病例的易感因素和早期干预对FRS病例的预后至关重要。

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引用次数: 0

Quiescent non-union: Acknowledging a discrete entity and comparing serological markers for diagnosis of infection at non-union site 静止不连：承认一个离散的实体和比较血清学标记诊断感染在不连部位

IF 1.3 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2026-01-01 DOI: 10.1016/j.ijmmb.2026.101044

Sandeep kumar Chaudhari , Mohit Dhingra , Mohit Bhatia

Background

Quiescent non-union refers to a state where a fracture fails to heal, and the site appears clinically inactive despite the possible presence of a dormant or low-grade infection. This condition often follows open fractures or prior surgical interventions. Although typical signs of infection—pain, swelling, or discharge—are absent, latent infections may reactivate, leading to severe complications. Diagnosing infection in such cases is challenging due to the lack of definitive tools, and clinicians typically rely on inflammatory markers like C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and total leukocyte count (TLC), though their reliability remains uncertain.

Objective

To determine the prevalence of infection in patients with quiescent non-union of long bone diaphyseal fractures and evaluate the diagnostic performance of various microbiological and serological tests.

Methodology

This cross-sectional study was conducted at a tertiary care centre from December 2019 to January 2022, involving 50 patients with long bone non-unions. Radiographs classified non-union types. Intraoperatively, four tissue samples (from bone ends and surrounding soft tissue) were collected for microbiological analysis. Preoperative blood samples assessed TLC, ESR, and CRP levels.

Results

Of 50 patients, 10 (20 %) had positive microbial cultures. Among serological tests, TLC had 20 % sensitivity and 56 % accuracy; ESR had 40 % sensitivity and 64 % accuracy. CRP demonstrated the highest sensitivity (60 %) and diagnostic accuracy (76 %).

Conclusion

Occult infection may be present in quiescent non-unions. CRP is the most reliable serological marker for detecting such hidden infections.

背景：静止不愈合是指骨折无法愈合的状态，尽管可能存在休眠或低级别感染，但该部位在临床上表现为无活性。这种情况通常发生在开放性骨折或先前的手术干预之后。虽然没有典型的感染症状——疼痛、肿胀或分泌物，但潜伏性感染可能会重新激活，导致严重的并发症。由于缺乏明确的工具，在这种情况下诊断感染是具有挑战性的，临床医生通常依赖于炎症标志物，如c反应蛋白（CRP）、红细胞沉降率（ESR）和总白细胞计数（TLC），尽管它们的可靠性仍不确定。目的了解长骨骨干骨折静态不愈合患者感染的流行情况，评价各种微生物学和血清学检查对长骨骨干骨折的诊断价值。该横断面研究于2019年12月至2022年1月在一家三级医疗中心进行，涉及50名长骨不连患者。x线片对骨不连类型进行分类。术中采集4份组织标本（骨端及周围软组织）进行微生物学分析。术前血液样本评估TLC、ESR和CRP水平。结果50例患者中，10例（20%）微生物培养阳性。在血清学检测中，TLC的灵敏度为20%，准确度为56%；ESR的灵敏度为40%，准确度为64%。CRP表现出最高的敏感性（60%）和诊断准确性（76%）。结论静态骨不连可能存在隐匿性感染。CRP是检测此类隐性感染最可靠的血清学标志物。

{"title":"Quiescent non-union: Acknowledging a discrete entity and comparing serological markers for diagnosis of infection at non-union site","authors":"Sandeep kumar Chaudhari , Mohit Dhingra , Mohit Bhatia","doi":"10.1016/j.ijmmb.2026.101044","DOIUrl":"10.1016/j.ijmmb.2026.101044","url":null,"abstract":"<div><h3>Background</h3><div>Quiescent non-union refers to a state where a fracture fails to heal, and the site appears clinically inactive despite the possible presence of a dormant or low-grade infection. This condition often follows open fractures or prior surgical interventions. Although typical signs of infection—pain, swelling, or discharge—are absent, latent infections may reactivate, leading to severe complications. Diagnosing infection in such cases is challenging due to the lack of definitive tools, and clinicians typically rely on inflammatory markers like C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and total leukocyte count (TLC), though their reliability remains uncertain.</div></div><div><h3>Objective</h3><div>To determine the prevalence of infection in patients with quiescent non-union of long bone diaphyseal fractures and evaluate the diagnostic performance of various microbiological and serological tests.</div></div><div><h3>Methodology</h3><div>This cross-sectional study was conducted at a tertiary care centre from December 2019 to January 2022, involving 50 patients with long bone non-unions. Radiographs classified non-union types. Intraoperatively, four tissue samples (from bone ends and surrounding soft tissue) were collected for microbiological analysis. Preoperative blood samples assessed TLC, ESR, and CRP levels.</div></div><div><h3>Results</h3><div>Of 50 patients, 10 (20 %) had positive microbial cultures. Among serological tests, TLC had 20 % sensitivity and 56 % accuracy; ESR had 40 % sensitivity and 64 % accuracy. CRP demonstrated the highest sensitivity (60 %) and diagnostic accuracy (76 %).</div></div><div><h3>Conclusion</h3><div>Occult infection may be present in quiescent non-unions. CRP is the most reliable serological marker for detecting such hidden infections.</div></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"59 ","pages":"Article 101044"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145920941","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}

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