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Microsphaeropsis arundinis: a coelomycetes and an emerging cause of human phaeohyphomycosis reported from Assam, India with review of the literature 环生微球孢:一种腔菌和一种新出现的人类褐丝酵母菌病的原因报道从阿萨姆邦,印度与文献回顾。
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-23 DOI: 10.1016/j.ijmmb.2025.100979
Reema Nath , Shyamanta Barua , Parashabina Shyam , Chaitali Konwar , Jubair Zaman Saikia , Aparna Dutta
Microsphaeropsis arundinis is an emerging cause of subcutaneous fungal infection among immunocompromised humans and cat. It is a dematiaceous fungus of class Coelomycetes, that inhabits plant host. Most of the cases from feline hosts and human immunocompromised hosts are reported from Australia [1]. We report a case of phaeohyphomycosis in a 28 year old female patient attending Dermatology OPD from Assam who is a known case of Systemic lupus Erythematosus since last 11 years on oral prednisolone therapy. Patient responded well to oral itraconazole therapy.
Phenotypic identification of this dematiaceous fungus is challenging and molecular dentification was done with ITS sequencing.
在免疫功能低下的人和猫中,周围微球孢是一种新出现的皮下真菌感染原因。它是一种地形菌纲的地形菌,栖息于植物寄主中。大多数来自猫宿主和人类免疫功能低下宿主的病例报告来自澳大利亚。我们报告了一个28岁的女性患者,在阿萨姆邦皮肤科的OPD就诊,她是一个已知的系统性红斑狼疮病例,自过去11年口服强的松龙治疗以来。患者口服伊曲康唑治疗效果良好。这种真菌的表型鉴定具有挑战性,分子鉴定是用ITS测序完成的。
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引用次数: 0
Co-occurrence of novel TEM-264 and NDM-88 in Escherichia coli isolated from urine sample of 72-year-Old female patient, Gujarat, India 新型TEM-264和NDM-88在印度古吉拉特邦72岁女性患者尿液分离的大肠埃希菌中共存。
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-22 DOI: 10.1016/j.ijmmb.2025.100980
Siddhi A. Darji, Devjani Banerjee
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引用次数: 0
Establishment of a multiplex real-time quantitative PCR assay using TaqMan fluorescent probes to detect Mucorales species TaqMan荧光探针多重实时定量PCR检测毛霉菌种类的建立。
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-20 DOI: 10.1016/j.ijmmb.2025.100977
Yongsheng Pan, Dan Pu, Hongren Xu, Kerong Jiang, Jiajie Wang, Minfeng Bai, Xiaoliang Xu, Yunping Zhao, Limin Yin

Purpose

To establish a specific and sensitive TaqMan multiplex real-time quantitative PCR (RT-qPCR) assay to rapidly detect Mucorales.

Methods

Customized oligonucleotide primers and corresponding detection probes were developed using the 18S ribosomal RNA gene sequences of Rhizomucor spp., Lichtheimia spp., and Mucor spp./Rhizopus spp. A multiplex RT-qPCR assay was established using TaqMan fluorescent probes, and its specificity, repeatability, and sensitivity were evaluated. The method was also used for the detection of simulated Mucorales-positive clinical samples and on samples from clinical patients possibly having fungal infections.

Results

The established TaqMan fluorescent probe-based multiplex RT-qPCR assay accurately detected Mucorales with high sensitivity, showing a minimum detection limit of 1 fg/μL. The assay also showed high specificity and accurately detected organisms representing the four main genera in Mucorales (i.e., Rhizomucor miehei, Lichtheimia corymbifera, Mucor circinelloides, and Rhizopus oryzae). Additionally, no cross-reactivity was observed with 21 non-targeted strains (including viruses, bacteria, fungi, and Cunninghamella bertholletiae). The reproducibility of the assay was confirmed, with a relative standard deviation within groups of less than 1 %. The assay was able to detect Mucorales pathogens (i.e., Rhizomucor spp., Lichtheimia spp., Mucor spp., and Rhizopus spp.) in simulated positive clinical specimens of blood, urine, lavage fluid, and sputum. Among 56 specimens from clinical patients with suspected fungal infections that were tested using the assay, one positive specimen was detected, consistent with the findings from sequencing and fungal culture identification.

Conclusions

A highly specific and sensitive TaqMan fluorescent probe-based multiplex RT-qPCR detection method for Mucorales was established that has promising applications in the early and rapid diagnosis of Mucorales pathogens in clinical specimens.
目的:建立特异、灵敏的TaqMan多重实时荧光定量PCR (RT-qPCR)快速检测毛霉菌的方法。方法:利用根霉属、Lichtheimia属和毛霉属/根霉属的18S核糖体RNA基因序列,开发定制的寡核苷酸引物和相应的检测探针。采用TaqMan荧光探针建立多重RT-qPCR检测方法,并对其特异性、重复性和灵敏度进行评价。该方法还可用于模拟mucorales阳性临床样品和可能有真菌感染的临床患者样品的检测。结果:建立的基于TaqMan荧光探针的多重RT-qPCR检测方法准确、灵敏度高,最低检测限为1 fg/μL。该方法还具有较高的特异性,能够准确地检测到毛霉属的4个主要属(即:米黑毛霉、冠状毛霉、环状毛霉和米根霉)。此外,21株非靶向菌株(包括病毒、细菌、真菌和贝氏坎宁哈默菌)未观察到交叉反应性。验证了该方法的重复性,组内相对标准偏差小于1%。该方法能够在血液、尿液、灌洗液和痰液的模拟阳性临床标本中检测到毛霉菌病原体(即根霉属、Lichtheimia属、毛霉菌属和根霉属)。在56例疑似真菌感染的临床患者标本中,检测到1例阳性标本,与测序和真菌培养鉴定结果一致。结论:建立了一种特异性高、灵敏度高的基于TaqMan荧光探针的Mucorales多重RT-qPCR检测方法,在临床标本中Mucorales病原菌的早期快速诊断中具有良好的应用前景。
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引用次数: 0
Acrophialophora jodhpurensis and Nocardia in idiopathic bronchiectasis: Colonizers or culprits?’ 特发性支气管扩张中的焦布氏嗜肺菌和诺卡菌:殖民者还是罪魁祸首?
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-18 DOI: 10.1016/j.ijmmb.2025.100975
Anjali Anil , Haseen Ahmad , Harsimran Kaur , Inderpaul Singh Sehgal , Sourav Agnihotri , Shivaprakash M. Rudramurthy
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引用次数: 0
A risk-based assessment of Enterococcal Bloodstream infection: Suggesting considerations in empirical therapy strategies in a tertiary care hospital 基于风险的肠球菌血流感染评估:建议在三级护理医院的经验治疗策略的考虑。
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-18 DOI: 10.1016/j.ijmmb.2025.100976
Pooja Kumar, Bhaskar Thakuria, Binod Kumar Pati, K. Prathyusha, Asim Sarfraz, Archana

Purpose

Enterococcal bloodstream infections (E-BSIs) pose a significant challenge due to their unique intrinsic and increasing resistance. Empirical treatment guidelines are often ineffective in E-BSI, as Antibiotic policies mainly address Gram-negative bacilli and MRSA for Hospital-acquired infection (HAI) in India.

Methods

The study was designed to investigate the risk factors, infection source, species profile, antimicrobial susceptibility and clinical outcomes in diagnosed E-BSI patients at a tertiary care centre in India.
From the blood culture samples from August 2022 to July 2023, 52 non-duplicate blood culture isolates of Enterococcus species were identified with categorisation of vancomycin resistance genes, and the patients were followed up for risk factors, probable sources, and ongoing therapies, with a switch to definitive therapy for the outcome.

Results

Of 52 confirmed E-BSI cases, the species distribution was as follows: E. faecium (61.5 %), E. faecalis (26.92 %), E. gallinarum (9.61 %), and E. durans (1.92 %). Antimicrobial resistance was significantly higher in E. faecium. Nine isolates (17.3 %) were vancomycin-resistant enterococci (VRE), with diverse outcomes. HAI comprised 44.23 % of cases. The overall mortality rate was 26.9 % and ICU patients had significantly higher mortality, with significant risk factors being invasive medical devices (59.6 %), followed by bedridden status (23 %) and immunosuppression (9.61 %). Significant risk factors included the presence of invasive medical devices (59.6 %), followed by a bedridden status (23.0 %) and immunosuppression (9.6 %). Patients with early empirical therapy that has enterococcal coverage showed a protective effect on survival. However, switching over to definitive therapy alone could not significantly reduce mortality.

Conclusion

This study underscores the importance of early empirical therapy with enterococcal coverage in high-risk patients. Timely initiation of empirical coverage appears more crucial than later definitive therapy adjustments in improving survival. Invasive device use remains a significant risk factor, reinforcing the need for stringent infection control to prevent HAI, including E-BSI.
目的:肠球菌血流感染(e - bsi)由于其独特的内在和日益增加的耐药性而构成重大挑战。经验性治疗指南在E-BSI中往往无效,因为印度的抗生素政策主要针对医院获得性感染(HAI)的革兰氏阴性杆菌和MRSA。方法:本研究旨在调查印度一家三级保健中心诊断的E-BSI患者的危险因素、感染源、物种特征、抗菌药物敏感性和临床结果。从2022年8月至2023年7月的血培养样本中,通过对万古霉素耐药基因的分类,鉴定出52株非重复血培养肠球菌,并对患者进行随访,了解危险因素、可能的来源和正在进行的治疗,并根据结果切换到明确的治疗。结果:在确诊的52例E-BSI病例中,细菌种类分布为:粪肠杆菌(61.5%)、粪肠杆菌(26.92%)、鸡肠杆菌(9.61%)和durans(1.92%)。粪肠杆菌对抗菌素的耐药性明显较高。9株(17.3%)为万古霉素耐药肠球菌(VRE),结果各不相同。HAI占44.23%。ICU患者的总死亡率为26.9%,死亡率明显高于ICU患者,主要危险因素为侵入性医疗器械(59.6%),其次为卧床状态(23%)和免疫抑制(9.61%)。重要的危险因素包括存在侵入性医疗器械(59.6%),其次是卧床(23.0%)和免疫抑制(9.6%)。有肠球菌覆盖的早期经验性治疗对患者的生存有保护作用。然而,单纯转向决定性治疗并不能显著降低死亡率。结论:本研究强调了对高危患者进行肠球菌覆盖的早期经验性治疗的重要性。在提高生存率方面,及时开始经验覆盖似乎比后来确定的治疗调整更重要。侵入性器械的使用仍然是一个重要的风险因素,因此需要严格控制感染以预防HAI,包括E-BSI。
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引用次数: 0
Management of infections caused by Extended-spectrum beta-lactamase-producing Enterobacterales in Indian patients 印度患者广谱β -内酰胺酶肠杆菌感染的管理。
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-16 DOI: 10.1016/j.ijmmb.2025.100974
Veeraraghavan Balaji , Nitin Bansal , Ram Gopalakrishnan , Camilla Rodrigues , V. Ramasubramanian , George M. Varghese , Vasant Nagvekar , Pallab Ray , Sanjay Bhattacharya , Neha Gupta , Priscilla Rupali , Rajalakshmi Ananthanarayanan , Sonam Vijay , Kamini Walia

Background

Extended-spectrum beta-lactamases (ESBLs), particularly in Enterobacterales, are major contributors to the growing problem of antibiotic resistance in Gram-negative bacilli. This guidance document provides an overview of the epidemiology, identification, and clinical management of infections caused by Extended-Spectrum Beta-Lactamase-producing Enterobacterales (ESBL-E). This guideline adds on the previously issued Indian Council of Medical Research (ICMR) guidelines on carbapenem-resistant organisms (CROs) and intended to support clinicians in making evidence-based decisions regarding the diagnosis and treatment of ESBL infections, thereby promoting effective patient management and antimicrobial stewardship.

Objectives

The purpose of this guidance document aims to assist clinicians in selecting not only the right antibiotics to diagnose ESBLs, but also right tests to diagnose ESBLs, for effective management of ESBL infections.

Content

This guidance document highlights the importance of early and accurate identification of ESBL -producing Enterobacterales, outlines clinical syndromes that may require empirical antibiotic coverage for ESBLs, and offers guidance on appropriate de-escalation strategies. Additionally, it emphasizes on the optimal use of use of newer beta-lactam/beta-lactamase inhibitor (BLBLI) combinations, such as cefepime-enmetazobactam and ceftolozane-tazobactam, and also emphasizes on avoiding important drugs like ceftazidime-avibactam for ESBL -producing Enterobacterales.
背景:广谱β -内酰胺酶(ESBLs),尤其是肠杆菌,是导致革兰氏阴性杆菌耐药性问题日益严重的主要原因。本指导文件概述了由广谱β -内酰胺酶(ESBL)产生的肠杆菌引起的感染的流行病学、鉴定和临床管理。该指南是对先前发布的ICMR碳青霉烯耐药生物(cro)指南的补充,旨在支持临床医生就ESBL感染的诊断和治疗做出基于证据的决策,从而促进有效的患者管理和抗菌药物管理。目的:本指导文件旨在帮助临床医生不仅选择正确的抗生素来诊断ESBL,而且选择正确的检测方法来诊断ESBL,从而有效地管理ESBL感染。内容:本指导文件强调了早期准确识别ESBL肠杆菌的重要性,概述了可能需要经经验抗生素覆盖ESBL的临床综合征,并提供了适当的降级策略指导。此外,它强调了使用较新的β -内酰胺/ β -内酰胺酶抑制剂(BLBLI)组合的最佳使用,如头孢吡肟-恩美他唑巴坦和头孢洛桑-他唑巴坦,并强调避免使用ESBL肠杆菌的重要药物,如头孢他啶-阿维巴坦。
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引用次数: 0
Screening for mutations in pmrB gene to predict potential colistin resistance among the clinical isolates of multidrug-resistant Acinetobacter baumannii 筛选pmrB基因突变预测多药耐药鲍曼不动杆菌临床分离株中潜在的粘菌素耐药性。
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-13 DOI: 10.1016/j.ijmmb.2025.100971
Sridevi Dinakaran , Patricia Anitha K. , Ajit R. Sawant , Sheela Devi Chandrakesan , Reba Kanungo

Purpose

Infections caused by multidrug-resistant Acinetobacter baumannii (MDR-AB) are a major global problem. Increasing resistance to carbapenems among Acinetobacter baumannii (A.baumannii) has led to using colistin as a last resort. Overuse of colistin will lead to the emergence of colistin resistance as evidenced in the past with other antibiotics. In India, reports of colistin-resistant A.baumannii are emerging. The mutations in the pmrA/pmrB genes may induce colistin resistance. However, increasing the minimum inhibitory concentration (MIC) of colistin and detection of mutations in the pmrB gene may provide information on the possibility of emerging resistance.

Methods

A total of 50 clinical isolates MDR-AB were subjected to colistin broth microdilution and colistin challenge test. Amongst them, five isolates that had slightly higher MIC were sequenced to detect mutations.

Results

Out of 50 isolates, 24 % were isolated from patients who sustained trauma due to road traffic accidents and the majority of them (96 %) required ventilator support. Twenty-seven (56 %) isolates were from patients who developed ventilator-associated pneumonia. The mortality rate was highest (71.4 %) among sepsis cases. The colistin MIC was in the susceptible range in all the isolates. Amongst the five isolates that had slightly higher MIC, only one had a mutation in the pmrB gene.

Conclusion

Due to antibiotic pressure, A.baumannii can develop resistance to colistin through genomic mutation. If this trend continues, colistin therapy will become ineffective. This can cause serious implications in the management, especially in critically ill patients. Through a stringent antimicrobial stewardship program (AMSP) the spread of resistance could be controlled.
目的:耐多药鲍曼不动杆菌(MDR-AB)引起的感染是一个重大的全球性问题。鲍曼不动杆菌(鲍曼不动杆菌)对碳青霉烯类药物的耐药性日益增加,导致使用粘菌素作为最后的手段。过度使用粘菌素将导致粘菌素耐药性的出现,正如过去其他抗生素所证明的那样。在印度,关于耐粘菌素的鲍曼杆菌的报告正在出现。pmrA/pmrB基因突变可能诱发粘菌素耐药性。然而,增加黏菌素的最低抑制浓度(MIC)和检测pmrB基因突变可能提供有关出现耐药性可能性的信息。方法:对临床分离的50株MDR-AB进行粘菌素肉汤稀释和粘菌素激发试验。对其中5株MIC稍高的菌株进行测序检测突变。结果:50株分离株中,24%是从道路交通事故创伤患者中分离出来的,其中大多数(96%)需要呼吸机支持。27株(56%)分离株来自发生呼吸机相关性肺炎的患者。脓毒症患者死亡率最高(71.4%)。所有菌株的黏菌素MIC均在敏感范围内。在MIC略高的5株分离株中,只有1株pmrB基因发生突变。结论:由于抗生素压力,鲍曼不动杆菌可通过基因突变对粘菌素产生耐药性。如果这种趋势继续下去,粘菌素治疗将变得无效。这可能对管理造成严重影响,特别是对危重患者。通过严格的抗菌药物管理计划(AMSP),可以控制耐药性的传播。
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引用次数: 0
Candida guilliermondii candidemia: A rare finding in a neonate with necrotizing enterocolitis guilliermondii念珠菌:新生儿坏死性小肠结肠炎的罕见发现。
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-11 DOI: 10.1016/j.ijmmb.2025.100969
Shweta Singh , Vivek Hada , Anchala Bharadwaj , Gaurav Gupta , Shubhangi Chaturvedi , Atul R. Rukadikar , Aroop Mohanty , Parul Singh
The incidence of candidemia due to non-albicans Candida is increasing worldwide in various surveillance studies. Gastrointestinal tract is considered as one of the portal of entry for potential sources of invasive infections. Necrotizing Enterocolitis (NEC) is a serious inflammatory condition of gastrointestinal tract in preterm infants. Here, we describe a case of NEC in a neonate associated with an invasive infection caused by the uncommon non-albicans Candida species, Candida guilliermondii.
在各种监测研究中,非白色念珠菌引起的念珠菌病的发病率正在全球范围内增加。胃肠道被认为是侵袭性感染的潜在传染源的入口之一。坏死性小肠结肠炎(NEC)是一种严重的早产儿胃肠道炎症。在这里,我们描述了一个病例NEC在新生儿与侵袭性感染引起的不常见的非白色念珠菌,念珠菌吉列蒙地。
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引用次数: 0
Molecular Metamorphosis and clinical ramifications: A study of sequence variants in acute bacterial meningitis 分子变态和临床后果:急性细菌性脑膜炎序列变异的研究
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-11 DOI: 10.1016/j.ijmmb.2025.100970
Debasish Biswal , Hitender Gautam , Varun Kumar , Sonu Tyagi , Yogesh Kumar , Sarita Mohapatra , Seema Sood , Benu Dhawan , Bimal Kumar Das
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引用次数: 0
First autochthonous case of cutaneous leishmaniasis from Gujarat—a non-endemic area in India 来自印度非流行地区古吉拉特邦的首例皮肤利什曼病本地病例
IF 1.3 4区 医学 Q4 IMMUNOLOGY Pub Date : 2025-09-06 DOI: 10.1016/j.ijmmb.2025.100958
Keyur Shah , Sanjeev Shah , Apurva Puvar , Atul Patel
Cutaneous leishmaniasis is endemic in more than 98 countries, and in India it was described in the Thar Desert in Rajasthan and parts of the Gangetic Plain. Many other states, notably Kerala, Jammu and Kashmir, Himachal Pradesh, and others, have been emerging endemic foci for cutaneous leishmaniasis in India. We are reporting the first autochthonous case of cutaneous leishmaniasis and adding the state of Gujarat to this list of emerging endemic areas for cutaneous leishmaniasis. This case will emphasise the need for clinical suspicion and diagnostic workup in patients presented with plaques over exposed body areas in Gujarat.
皮肤利什曼病在超过98个国家流行,在印度拉贾斯坦邦的塔尔沙漠和恒河平原的部分地区也有报道。许多其他邦,特别是喀拉拉邦、查谟和克什米尔、喜马偕尔邦等邦,已成为印度皮肤利什曼病的地方性疫源地。我们正在报告首例本土皮肤利什曼病病例,并将古吉拉特邦列入皮肤利什曼病新发流行地区名单。该病例将强调对古吉拉特邦暴露身体部位出现斑块的患者进行临床怀疑和诊断检查的必要性。
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引用次数: 0
期刊
Indian Journal of Medical Microbiology
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