Indian Journal of Medical Microbiology最新文献_第5页

Microbial profiling, antimicrobial resistance surveillance, and molecular detection of MecA gene in Staphylococcal strains from donor human milk: Insights from a milk bank investigation 捐赠人乳中葡萄球菌菌株的微生物谱分析、抗菌药耐药性监测和 MecA 基因的分子检测：牛奶银行调查的启示。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-09-30 DOI: 10.1016/j.ijmmb.2024.100733

Astha Yadav , Sheetal Verma , Vimala Venkatesh , Amita Jain , Mala Kumar , Saurabh Kashyap , Shalini Tripathi

Purpose

Donor human milk (DHM) from milk banks provides vital nutrition to vulnerable infants. Understanding its microbial profile and antimicrobial resistance patterns is crucial for ensuring its safety and efficacy. This study aimed to profile the microbial composition, detect antibiotic resistance, and identify the presence of mecA gene in Staphylococcal strains from DHM samples.

Materials and method

A total of 151 DHM samples were collected from a regional human milk bank in North India. Microbial identification was performed using MALDI TOF MS, and antimicrobial susceptibility testing was conducted using the disc diffusion method. Molecular methods, including PCR, were employed for mecA gene detection.

Results

The study revealed a diverse microbial profile, with Staphylococcus species being predominant. Acinetobacter and Pseudomonas species were also prevalent, raising concerns due to their association with healthcare-associated outbreaks. High rates of antibiotic resistance were observed across both Gram-positive and Gram-negative bacteria, with resistance to commonly used antibiotics such as penicillin, clindamycin, erythromycin, and ceftriaxone. The mecA gene, associated with methicillin resistance, was detected in a significant proportion of Staphylococcal isolates.

Conclusion

The study underscores the importance of rigorous microbial analysis and antimicrobial susceptibility testing in assessing the safety of DHM. The presence of diverse microbial species, including antibiotic-resistant strains and the mecA gene in Staphylococcal strains, emphasizes the need for stringent hygiene practices and continuous surveillance in milk banks. Implementing comprehensive screening protocols and adhering to best practices in milk handling and pasteurization are crucial for safeguarding the health of vulnerable infants reliant on donor milk.

目的：来自母乳库的捐赠人乳（DHM）为脆弱婴儿提供了重要的营养。了解其微生物特征和抗菌药耐药性模式对确保其安全性和有效性至关重要。本研究旨在分析 DHM 样品中的微生物组成、检测抗生素耐药性并确定葡萄球菌菌株中是否存在 mecA 基因：从北印度的一个地区母乳库中共收集了 151 份母乳样本。使用 MALDI TOF MS 进行微生物鉴定，并使用碟片扩散法进行抗菌药敏感性测试。在检测 mecA 基因时采用了包括 PCR 在内的分子方法：结果：研究显示微生物种类繁多，以葡萄球菌为主。不动杆菌和假单胞菌也很普遍，由于它们与医疗相关疾病的爆发有关，因此引起了人们的关注。革兰氏阳性和革兰氏阴性细菌的抗生素耐药率都很高，对青霉素、克林霉素、红霉素和头孢曲松等常用抗生素都有耐药性。在相当大比例的葡萄球菌分离物中检测到了与甲氧西林耐药性相关的 mecA 基因：本研究强调了严格的微生物分析和抗菌药敏感性测试对评估 DHM 安全性的重要性。牛奶中存在多种微生物，包括抗生素耐药菌株和葡萄球菌菌株中的 mecA 基因，这强调了在奶库中实施严格的卫生规范和持续监控的必要性。实施全面的筛查方案并坚持牛奶处理和巴氏杀菌的最佳做法，对于保障依赖捐献牛奶的脆弱婴儿的健康至关重要。

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引用次数: 0

A systematic review and meta-analysis to develop a landscape map of antibiotic resistance for six WHO priority pathogens in east and north-east India from 2011 to 2022 为绘制 2011 年至 2022 年印度东部和东北部六种世界卫生组织重点病原体的抗生素耐药性分布图而进行的系统回顾和元分析。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-09-25 DOI: 10.1016/j.ijmmb.2024.100732

Simran Malik , Chetan Mahadev Shirvankar , Rahul Kurian Jacob , Debashree Guha Adhya , Subir Sinha , Sanjay Bhattacharya , Kamini Walia , Sangeeta Das Bhattacharya

Background

Determining regional patterns of antimicrobial resistance in bacterial infections in the healthcare setting (AMR) identifies surveillance gaps and informs policies for mitigation. We estimated the prevalence of AMR for six WHO priority pathogens in diagnostic and surveillance samples in the twelve east and north-east Indian states from 2011 to 2022 (PROSPERO ID: CRD42021278961).

Methods

Studies were searched on Medline, Scopus, and Web of Science. Observational, descriptive, and cross-sectional studies, reporting AMR based on laboratory diagnostics, in individuals from east and north-east India from 2011 to 2022 were included. Four reviewers in pairs conducted abstract, full-text screening, and data extraction. We estimated the prevalence of resistance in fifty-four pathogen-antibiotic combinations, and six antibiotic resistance patterns. Pooled estimates of prevalence (Ɵ), heterogeneity (I²), and 95 % confidence intervals were calculated using the random effects model.

Results

Fifty-five studies were included. Information was available for nine states, none from Arunachal Pradesh, Mizoram, and Nagaland. E. coli was most frequently isolated (59.2 %, 95 % CI: 48.8–69.6 %), followed by S. aureus (36.2 %, 95 % CI: 20.2–52.2 %), Enterococcus (27.5 %, 95 % CI: 11.2–43.7 %), Klebsiella (25 %, 95 % CI: 15–35 %), Acinetobacter (15.7 %, 95 % CI: 2.3–29.1 %), and Pseudomonas aeruginosa (15.7 %, 95 % CI: 4.1–27.3 %). There was high prevalence of ESBL (45 %, 95 % CI: 35–55 %) and carbapenem resistance (30 %, 95 % CI: 22–38 %). AmpC (23 %, 95 % CI: 9–37 %) and colistin resistance was lower (10 %, 95 % CI: 0–22 %) but supporting data was limited. Overall prevalence of MRSA was 26 % (95 % CI: 14–39 %), and VRE was 9 % (95 % CI: 0–17 %).

Conclusion

High prevalence of resistance was seen to all first-line antibiotics. Gram positive bacteria had high resistance to penicillins, and Gram negatives to third-generation cephalosporins, beta-lactam/beta-lactamase inhibitors, and carbapenems. Aminoglycoside, fluoroquinolone, and trimethoprim-sulphamethoxazole resistance was common across all genera. Critical regional AMR information gaps exist.

背景：确定医疗环境中细菌感染的抗菌药耐药性（AMR）的区域模式可以发现监测差距，并为缓解政策提供信息。我们估计了 2011 年至 2022 年印度东部和东北部十二个邦的诊断和监测样本中六种世界卫生组织优先病原体的 AMR 流行率（PROSPERO ID：CRD42021278961）：方法：在 Medline、Scopus 和 Web of Science 上搜索相关研究。方法：在 Medline、Scopus 和 Web Science 上检索了 2011 年至 2022 年期间根据实验室诊断报告印度东部和东北部个人 AMR 的观察性、描述性和横断面研究。四名审稿人结对进行摘要、全文筛选和数据提取。我们估算了 54 种病原体-抗生素组合和 6 种抗生素耐药性模式的耐药性流行率。使用随机效应模型计算了流行率的汇总估计值（Ɵ）、异质性（I2）和95%置信区间：结果：共纳入 55 项研究。结果：共纳入 55 项研究，其中 9 个州有相关资料，阿鲁纳恰尔邦、米佐拉姆邦和那加兰邦没有相关资料。大肠杆菌最常被分离出来（59.2%，95% CI：48.8-69.6%），其次是金黄色葡萄球菌（36.2%，95% CI：20.2-52.2%）、肠球菌（27.5%，95% CI：11.2-43.7%）、克雷伯氏菌（25%，95% CI：15-35%）、醋杆菌（15.7%，95% CI：2.3-29.1%）和铜绿假单胞菌（15.7%，95% CI：4.1-27.3%）。ESBL（45%，95% CI：35-55%）和碳青霉烯耐药率较高（30%，95% CI：22-38%）。AmpC（23%，95% CI：9-37%）和可乐定耐药率较低（10%，95% CI：0-22%），但支持数据有限。MRSA 的总体流行率为 26%（95% CI：14-39%），VRE 为 9%（95% CI：0-17%）：结论：所有一线抗生素的耐药率都很高。革兰氏阳性菌对青霉素类耐药率高，革兰氏阴性菌对第三代头孢菌素、β-内酰胺/β-内酰胺酶抑制剂和碳青霉烯类耐药率高。氨基糖苷类、氟喹诺酮类和三甲氧苄氨嘧啶-磺胺甲噁唑的耐药性在所有菌属中都很常见。地区 AMR 信息存在严重缺口。

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引用次数: 0

A case report and literature review of nontuberculous mycobacterial disease caused by Mycolicibacter kumamotonensis 由库马莫托分枝杆菌引起的非结核分枝杆菌病病例报告和文献综述

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-09-12 DOI: 10.1016/j.ijmmb.2024.100731

Ayano Watanabe , Takehisa Sano , Kenta Murayama , Ryota Miyamoto , Junya Kamei , Toshihiro Masuda , Suguru Kojima , Kyoko Hijiya , Masato Fujii

Herein, we report a rare case of pulmonary nontuberculous mycobacterial (NTM) infection caused by Mycolicibacter kumamotonensis in a 73-year-old man successfully treated with clarithromycin, rifampicin, and ethambutol. Seven cases of NTM disease caused by M. kumamotonensis have been previously described, with characteristics differing from those of more common NTM diseases.

在此，我们报告了一例罕见的由库马莫托分枝杆菌（Mycolicibacter kumamotonensis）引起的肺部非结核分枝杆菌（NTM）感染病例，该患者 73 岁，接受克拉霉素、利福平和乙胺丁醇治疗后获得成功。以前曾描述过七例由库马莫托分枝杆菌引起的非结核分枝杆菌病，其特征与更常见的非结核分枝杆菌病不同。

引用次数: 0

Next generation sequencing to detect pathogens causing paediatric community-acquired pneumonia - A systematic review and meta-analysis 下一代测序检测导致儿科社区获得性肺炎的病原体--系统综述和元分析。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-09-11 DOI: 10.1016/j.ijmmb.2024.100730

Kiran Chawla , Rosemary Shaji , Nayana Siddalingaiah , Sreenath Menon P K , Sangeetha M D , Leslie Edward S. Lewis , Sharath Burugina Nagaraja

Background

Paediatric community-acquired pneumonia (CAP) is a major public health challenge in children, requiring accurate and timely diagnosis of causative pathogens for effective antibiotic treatment. We aimed to explore the utility of next-generation sequencing (NGS) in precise diagnosis of pediatric CAP and its effect on treatment outcome of these children.

Methods

A systematic review and meta-analysis was conducted to compare NGS-guided antibiotic therapy with conventional methods in pediatric CAP. The study followed PRISMA guidelines and searched for electronic databases including PubMed/MEDLINE, Embase, Scopus, and Web of Sciences from 2012 to 2023. Studies on pediatric CAP (<18 years) using NGS alongside conventional diagnostics, were included.

Results

Database search identified 721 studies and 6 were finally included for review, published between 2019 and 2023. Meta-analysis revealed an overall odds ratio of 2.39 (95 % CI 1.22, 3.56) for NGS vs conventional methods. Detection rates using NGS ranged from 86% to 100 %, surpassing conventional methods (26%–78.51 %). Five out of selected 6 studies (83.33 %) have documented that change in treatment based on NGS finding resulted in clinical improvement of patients. There was no significant heterogeneity and potential bias among the studies. Nearly 80 % of the studies were of good quality.

Conclusion

The NGS (particularly metagenomic sequencing) is a promising tool for diagnosing paediatric CAP with high accuracy. It can improve antibiotic usage practices and patient outcomes, potentially reducing antibiotic resistance. Based on meta-analysis, training of healthcare professionals in NGS methodologies and result interpretation is highly recommended.

背景：小儿社区获得性肺炎（CAP）是儿童面临的一项重大公共卫生挑战，需要及时准确地诊断致病病原体，以便进行有效的抗生素治疗。我们旨在探索下一代测序（NGS）在精确诊断小儿 CAP 中的作用及其对这些儿童治疗效果的影响：我们进行了一项系统综述和荟萃分析，以比较 NGS 指导的抗生素疗法与传统方法在小儿 CAP 中的应用。研究遵循 PRISMA 指南，检索了 2012 年至 2023 年的电子数据库，包括 PubMed/MEDLINE、Embase、Scopus 和 Web of Sciences。关于儿科 CAP 的研究（结果：数据库搜索确定了 721 项研究，最终纳入 6 项研究进行审查，这些研究发表于 2019 年至 2023 年。Meta 分析显示，NGS 与传统方法的总体几率比为 2.39（95% CI 1.22，3.56）。使用 NGS 的检测率介于 86%-100% 之间，超过了传统方法（26%-78.51%）。在所选的 6 项研究中，有 5 项（83.33%）研究表明，根据 NGS 的发现改变治疗方法可使患者的临床症状得到改善。这些研究之间不存在明显的异质性和潜在偏倚。近 80% 的研究质量良好：结论：NGS（尤其是元基因组测序）是诊断儿科 CAP 的一种前景广阔的高精度工具。它可以改善抗生素使用方法和患者预后，并有可能减少抗生素耐药性。根据荟萃分析，强烈建议对医护人员进行 NGS 方法和结果解读方面的培训。

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引用次数: 0

The burden of tuberculosis among patients with non-small cell lung carcinoma in a tertiary care center 一家三级医疗中心非小细胞肺癌患者的结核病负担。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-09-05 DOI: 10.1016/j.ijmmb.2024.100729

Niranjan Mahishi , Kiran Bala , Prabhat Malik , Piyush Ranjan , Arvind Kumar , Manish Soneja , Anant Mohan , Urvashi B. Singh

Background

Lung cancer and tuberculosis share similar risk factors, clinical spectrum, radiological features and it is difficult to differentiate but it is important to diagnose both conditions for targeted therapy and better outcome.

Aims

Our primary objective was to estimate the proportion of TB in primary biopsy proven non-small cell lung carcinoma (NSCLC) cases.

Material & methods

This prospective observational study was conducted in the Departments of Medicine/Pulmonary Medicine/Medical Oncology and Microbiology at the All India Institute of Medical Sciences, New Delhi for a period of 2 years (January 2020–December 2021). Patients with biopsy proven, primary non-small cell lung cancer were recruited and sputum samples were subjected to microbiological investigations to confirm tuberculosis. Comparison was done in two groups of lung cancer patients with confirmed TB (Group A) and without confirmed tuberculosis (Group B).

Results

Total 75 patients with biopsy proven, primary NSCLC were recruited and 16 % (12/75) were diagnosed with confirmed TB. Adenocarcinoma (36.48 %) and Squamous cell carcinoma (33.44 %) were the two predominant histopathological subtypes of NSCLC. About 57 (76 %) of them were found to be in stage IV of Lung cancer at initial presentation itself (75 % in group A & 74.6 % in group B; p value < 0.80). A majority of patients (11/12 cases; 91 %) of group A were males with a mean age of 59 ± 7.5 years. The upper lobes of the lung were involved in 65 % (49/75) of the cases and showing a mass lesion on imaging (75 % in group A & 65 % in group B; p value < 0.52). Kaplan Meier survival revealed a median survival time of 11 months in subjects with only NSCLC and a median survival time of 4 months in the group with concomitant TB and NSCLC (p value < 0.44).

背景：肺癌和肺结核具有相似的风险因素、临床表现和放射学特征，很难区分，但诊断这两种疾病对于进行有针对性的治疗和获得更好的治疗效果非常重要：这项前瞻性观察研究在新德里全印度医学科学研究所（All India Institute of Medical Sciences, New Delhi）的内科/肺科/肿瘤科和微生物科进行，为期两年（2020 年 1 月至 2021 年 12 月）。研究人员招募了经活检证实患有原发性非小细胞肺癌的患者，并对痰液样本进行微生物学检查，以确认是否患有肺结核。对已确诊肺结核（A 组）和未确诊肺结核（B 组）的两组肺癌患者进行比较：共招募了 75 名经活检证实的原发性 NSCLC 患者，其中 16%（12/75）被确诊为肺结核。腺癌（36.48%）和鳞状细胞癌（33.44%）是 NSCLC 的两种主要组织病理学亚型。其中约有 57 人（76%）在初次就诊时就已处于肺癌 IV 期（A 组为 75%，B 组为 74.6%；P 值为 0.05）。

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引用次数: 0

Carbapenem resistance in Enterobacterales: Predicting clinical outcomes in bloodstream infections 肠杆菌的碳青霉烯耐药性：预测血流感染的临床结果。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-09-04 DOI: 10.1016/j.ijmmb.2024.100728

Amani Alnimr

Purpose

Carbapenem-resistant Enterobacterales (CRE) are a global concern due to their high mortality rates and limited therapeutics. CRE-caused bloodstream infections (BSIs) are challenging to manage, especially in healthcare settings. This study aimed to investigate the predictors of mortality in BSI patients caused by CRE.

Methods

A single center prospective study to examine the characteristics of BSI caused by CRE in a large academic hospital over 15 months. The main outcomes were microbiological characteristics and clinical outcomes of patients at 28 days based on a step-wise regression analysis.

Results

A total of 76 episodes of BSI due to CRE were included. The study found that the most common type of carbapenemase was OXA-48 (69.7 %, n = 53), followed by the co-existence of OXA-48 and MBL (26.3 %, n = 20), with Klebsiella pneumoniae being the most common (90 %, n = 69). Patients with OXA-48-BSI were more likely to have a urinary source of infection, while patients with MBL-BSI were more likely to have a non-urinary source of infection. All cases (100 %) had medical devices. Around 30.3 % of patients received effective empirical treatment, while 61.8 % received adequate therapy at 48 h. The overall mortality rate was 42.1 % (n = 32), and the main predictors of mortality in this study were the presence of sepsis and inadequate initial therapy, while age >65 predicted mortality in the linear regression but not the stepwise regression model.

Conclusion

CRE-BSIs are a serious health threat. The study highlights the need for preventive strategies focused on high-risk patients and proper device management to reduce BSI.

目的：耐碳青霉烯类肠杆菌（CRE）死亡率高、治疗手段有限，是全球关注的问题。由 CRE 引起的血流感染（BSI）在管理上具有挑战性，尤其是在医疗机构中。本研究旨在调查由 CRE 引起的 BSI 患者的死亡率预测因素：单中心前瞻性研究：在一家大型学术医院开展，历时 15 个月，研究由 CRE 引起的 BSI 的特征。主要结果是基于逐步回归分析的微生物学特征和患者 28 天后的临床结果：结果：共纳入 76 例 CRE 引起的 BSI。研究发现，最常见的碳青霉烯酶类型是OXA-48（69.7%，n = 53），其次是OXA-48和MBL并存（26.3%，n = 20），肺炎克雷伯菌最常见（90%，n = 69）。OXA-48-BSI 患者更可能有泌尿系统感染源，而 MBL-BSI 患者更可能有非泌尿系统感染源。所有病例（100%）都有医疗设备。约 30.3% 的患者接受了有效的经验性治疗，61.8% 的患者在 48 小时内接受了适当的治疗。总死亡率为 42.1%（32 人），本研究中预测死亡率的主要因素是出现败血症和初始治疗不足，而年龄大于 65 岁的患者在线性回归模型中可以预测死亡率，但在逐步回归模型中则不能：结论：CRE-BSI 是一种严重的健康威胁。本研究强调了针对高危患者采取预防策略和对设备进行适当管理以减少 BSI 的必要性。

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引用次数: 0

Aims and Scope 目标和范围

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-09-01 DOI: 10.1016/S0255-0857(24)00190-7

引用次数: 0

Development and validation of a pentaplex PCR assay for rapid detection of blaCTX-M, blaOXA–1, blaCMY, blaNDM and the PBP3 insert in Enterobacterales 开发并验证用于快速检测肠杆菌中 blaCTX-M、blaOXA-1、blaCMY、blaNDM 和 PBP3 插入物的五重 PCR 法。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-08-30 DOI: 10.1016/j.ijmmb.2024.100710

Yamuna Devi Bakthavatchalam , Fizaa Abdullah , Devishree Srinivasan , Sangeetha Nithiyanandam , Ayyanraj Neeravi , Poojah Shah , Nivedhana Subburaju , Subha Vajjiravelu Jaganathan , Rema Devi , Gita Nataraj , Binesh Lal Yesudason , Kamini Walia , Balaji Veeraraghavan

Background

There is a high diversity of beta-lactamases in gram negative pathogens, making them difficult to treat. In the presence of OXA-1 and ampC, PTZ is no longer clinically relevant when treating Enterobacterales expressing ESBLs. Further, MBL infections are often treated with the combination of ceftazidime/avibactam with aztreonam. . It has recently been reported that NDM-expressing E. coli isolates co-harboring PBP3 insert develops resistance to this triple combination.

Methods

A pentaplex PCR is developed and validated to simultaneously detect bla_CTX-M, bla_OXA-1, bla_CMY, bla_NDM, and the PBP3 insert in whole genome sequenced E. coli and K. pneumoniae isolates. In addition, the isolates chosen for pentaplex PCR evaluation were tested for their minimum inhibitory concentrations (MICs) against piperacillin/tazobactam, cefoperazone/sulbactam (C/S), ertapenem, imipenem, meropenem, ceftazidime/avibactam, aztreonam/avibactam, cefepime/taniborbactam, and cefiderocol.

Results

The developed pentaplex PCR showed 100 % reproducibility with the antimicrobial resistance profile generated from whole genome sequenced data. PTZ and C/S are not effective against ESBL and/or OXA-1 expressing E. coli and K. pneumoniae isolates and do not offer any activity against CMY co-producers. Further, the combined effect of CMY, NDM and PBP3 inserts impacts aztreonam/avibactam activity and reduces the susceptibility to 40 % in E. coli isolates. While, aztreonam/avibactam showed potent activity against NDM-expressing K. pneumoniae isolates. Importantly, cefepime/taniborbactam and cefiderocol showed limited activity against NDM-expressing E. coli and K. pneumoniae isolates.

Conclusion

The pentaplex PCR was effective in detecting four beta-lactamases (bla_CTX-M, bla_OXA-1, bla_CMY, bla_NDM) as well as PBP3 inserts. It is expected that using pentaplex PCR as a diagnostic test for resistance detection in clinical practice will improve patient outcomes by providing prompt and targeted treatment.

背景：革兰氏阴性病原体中的β-内酰胺酶种类繁多，因此难以治疗。由于存在 OXA-1 和 ampC，在治疗表达 ESBLs 的肠杆菌时，PTZ 不再具有临床意义。此外，MBL 感染通常使用头孢唑肟/阿维菌素和阿曲南来联合治疗。最近有报道称，表达 NDM 的大肠杆菌分离物中同时存在 NDM，并对这种三联疗法产生耐药性：方法：开发并验证了五重 PCR，用于检测全基因组测序分离物中的 blaCTX-M、blaOXA-1、blaCMY、blaNDM 和 PBP3 插入物。此外，还检测了被选作五重 PCR 评估的分离株对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦（C/S）、厄他培南、亚胺培南、美罗培南、头孢唑肟/阿维巴坦、阿曲南/阿维巴坦、头孢吡肟/他尼巴坦和头孢克肟的最低抑菌浓度（MICs）：所开发的五联 PCR 与全基因组测序数据生成的抗菌药物耐药性图谱具有 100% 的重现性。PTZ 和 C/S 对表达 ESBL 和/或 OXA-1 的大肠杆菌和肺炎双球菌分离物无效，对 CMY 协同产生者也没有任何活性。此外，CMY、NDM 和 PBP3 插入物的共同作用会影响阿曲南药/阿维菌素的活性，并将大肠杆菌分离物的易感性降低至 40%。同时，唑曲南/阿维巴坦对表达 NDM 的肺炎克氏菌分离物显示出强大的活性。重要的是，头孢吡肟/他尼巴坦和头孢克肟对表达 NDM 的大肠杆菌和肺炎双球菌分离物的活性有限：五重 PCR 能有效检测四种 beta-内酰胺酶（blaCTX-M、blaOXA-1、blaCMY 和 blaNDM）以及 PBP3 插入物。预计在临床实践中使用五重 PCR 作为耐药性检测诊断试验将能提供及时和有针对性的治疗，从而改善患者的预后。

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引用次数: 0

Breaking new ground: First case of keratitis by Apiospora 开辟新天地：首例 Apiospora 引起的角膜炎。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-08-29 DOI: 10.1016/j.ijmmb.2024.100711

Diptanu Paul , Bruttendu Moharana , Shraddha B. Sawant , Supriya Sahu , Subhasmita Bahinapati , Madhuchhanda Das , Vinaykumar Hallur

Fungi belonging to Apiospora are phytopathogens not reported from human infections. Here, we report a case of keratitis due to Apiospora species in a carpenter who sustained a bamboo shrapnel injury to his eye when he was not wearing safety goggles. Thin hyaline septate hyphae were found on calcofluor white with potassium hydroxide (Calco-KOH) preparation of the scraping. A nonsporulating white mold grew from the corneal scrape, identified as A. rasikravindrae by Internal Transcribed Spacer (ITS) region sequencing. The patient improved with debridement and topical antifungal therapy. Educational interventions are needed to encourage safety goggles to prevent corneal injuries and blindness.

Apiospora 属真菌是植物病原体，在人类感染病例中未见报道。在此，我们报告了一例由 Apiospora 菌引起的角膜炎病例，患者是一名木匠，他的眼睛被竹弹片击伤，当时他没有佩戴安全护目镜。在氢氧化钾钙氟白粉（Calco-KOH）制备的刮片上发现了细长的透明隔膜菌丝。角膜刮片上长出了一种无孢子的白色霉菌，通过内部转录间隔区（ITS）测序鉴定为 A. rasikravindrae。经过清创和局部抗真菌治疗，患者病情有所好转。需要采取教育干预措施，鼓励佩戴安全护目镜，以防止角膜受伤和失明。

引用次数: 0

Diagnostic accuracy of truenat MTB plus for the detection of pulmonary and extrapulmonary tuberculosis truenat MTB plus 检测肺部和肺外结核病的诊断准确性。

IF 1.4 4区医学 Q4 IMMUNOLOGY

Indian Journal of Medical Microbiology

Pub Date : 2024-08-24 DOI: 10.1016/j.ijmmb.2024.100709

Reena Anie Jose , Leeberk Raja Inbaraj , Ria Catherine Vincent , Adhin Baskar , Renu Mathew

Background

The diagnosis of Tuberculosis (TB) has been a challenge till the advent of rapid molecular diagnostic tests. The traditional diagnostic tests have its own limitations with regard to its performance or the turnaround time. Truenat MTB Plus assay, a battery-operated molecular assay developed in India has been introduced for its use in pulmonary TB (PTB). However, the diagnostic accuracy of the assay is not well studied in comparison with Mycobacterial culture, especially for extrapulmonary TB (EPTB).

Aim

We aimed at evaluating the diagnostic accuracy of Truenat MTB Plus assay for both PTB and EPTB comparing with culture for adult population.

Methods

The specimens from presumptive PTB and EPTB patients were processed for Truenat MTB Plus assay, solid or liquid culture and AFB staining. The electronic data of all the specimen reports collected retrospectively were analysed for the sensitivity and specificity.

Results

Out of the 736 samples which had valid culture reports, 364 (49.4 %) were respiratory and 372 (50.6 %) were extrapulmonary specimens. The test positivity rate for smear microscopy, Truenat MTB Plus assay and culture was 3.7 % (27), 8.2 % (60), 7.1 % (52) respectively. Of the 60 Truenat MTB Plus positive patients with TB, 33 (55 %) were PTB and 27 (45 %) were EPTB. We estimated overall sensitivity and specificity of Truenat MTB Plus as 90 % (95 % CI: 73.4–97.8) and 98. 2 (95 % CI:96–99.3) respectively for the detection of PTB. The overall sensitivity and specificity for EPTB was 81.8 % (95 % CI: 59.7–94.8) and 97.4 % (95 % CI: 95.1–98.8) respectively.

Conclusions

Truenat MTB Plus assay has comparable diagnostic accuracy with other molecular assays. The Truenat MTB Plus assay can be used for the diagnosis of PTB and EPTB, especially in resource limited settings.

背景：在快速分子诊断测试出现之前，结核病（TB）的诊断一直是个难题。传统的诊断测试在性能或周转时间方面有其自身的局限性。Truenat MTB Plus 检测法是印度开发的一种电池驱动分子检测法，已被用于肺结核（PTB）的检测。目的：我们旨在评估 Truenat MTB Plus 检测法与培养法相比对成人肺结核和肺结核的诊断准确性：对推定为 PTB 和 EPTB 患者的标本进行 Truenat MTB Plus 检测、固体或液体培养和 AFB 染色。对回顾性收集的所有标本报告的电子数据进行灵敏度和特异性分析：在 736 份有有效培养报告的样本中，364 份（49.4%）为呼吸道样本，372 份（50.6%）为肺外样本。涂片显微镜检查、Truenat MTB Plus 检测和培养的阳性率分别为 3.7 %（27 例）、8.2 %（60 例）和 7.1 %（52 例）。在 60 名 Truenat MTB Plus 检测呈阳性的肺结核患者中，33 人（55%）为 PTB，27 人（45%）为 EPTB。我们估计 Truenat MTB Plus 的总体灵敏度和特异性分别为 90 %（95 % CI：73.4-97.8）和 98.2（95 % CI：96-99.3）。对 EPTB 的总体敏感性和特异性分别为 81.8 %（95 % CI：59.7-94.8）和 97.4 %（95 % CI：95.1-98.8）：Truenat MTB Plus 检测法的诊断准确性与其他分子检测法相当。Truenat MTB Plus 检测法可用于诊断 PTB 和 EPTB，尤其是在资源有限的情况下。

{"title":"Diagnostic accuracy of truenat MTB plus for the detection of pulmonary and extrapulmonary tuberculosis","authors":"Reena Anie Jose , Leeberk Raja Inbaraj , Ria Catherine Vincent , Adhin Baskar , Renu Mathew","doi":"10.1016/j.ijmmb.2024.100709","DOIUrl":"10.1016/j.ijmmb.2024.100709","url":null,"abstract":"<div><h3>Background</h3><p>The diagnosis of Tuberculosis (TB) has been a challenge till the advent of rapid molecular diagnostic tests. The traditional diagnostic tests have its own limitations with regard to its performance or the turnaround time. Truenat MTB Plus assay, a battery-operated molecular assay developed in India has been introduced for its use in pulmonary TB (PTB). However, the diagnostic accuracy of the assay is not well studied in comparison with Mycobacterial culture, especially for extrapulmonary TB (EPTB).</p></div><div><h3>Aim</h3><p>We aimed at evaluating the diagnostic accuracy of Truenat MTB Plus assay for both PTB and EPTB comparing with culture for adult population.</p></div><div><h3>Methods</h3><p>The specimens from presumptive PTB and EPTB patients were processed for Truenat MTB Plus assay, solid or liquid culture and AFB staining. The electronic data of all the specimen reports collected retrospectively were analysed for the sensitivity and specificity.</p></div><div><h3>Results</h3><p>Out of the 736 samples which had valid culture reports, 364 (49.4 %) were respiratory and 372 (50.6 %) were extrapulmonary specimens. The test positivity rate for smear microscopy, Truenat MTB Plus assay and culture was 3.7 % (27), 8.2 % (60), 7.1 % (52) respectively. Of the 60 Truenat MTB Plus positive patients with TB, 33 (55 %) were PTB and 27 (45 %) were EPTB. We estimated overall sensitivity and specificity of Truenat MTB Plus as 90 % (95 % CI: 73.4–97.8) and 98. 2 (95 % CI:96–99.3) respectively for the detection of PTB. The overall sensitivity and specificity for EPTB was 81.8 % (95 % CI: 59.7–94.8) and 97.4 % (95 % CI: 95.1–98.8) respectively.</p></div><div><h3>Conclusions</h3><p>Truenat MTB Plus assay has comparable diagnostic accuracy with other molecular assays. The Truenat MTB Plus assay can be used for the diagnosis of PTB and EPTB, especially in resource limited settings.</p></div>","PeriodicalId":13284,"journal":{"name":"Indian Journal of Medical Microbiology","volume":"51 ","pages":"Article 100709"},"PeriodicalIF":1.4,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046620","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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