International Journal of Infectious Diseases最新文献

Background: Marburg Virus Disease (MVD) poses a significant global health risk due to its high case fatality rates (24%-88%) and the diagnostic challenges posed by its non-specific early symptoms, which overlap with other febrile illnesses like malaria. This study analyzed symptom patterns from the 2024 MVD outbreak in Rwanda to refine case definitions and enhance early detection.

Methods: A retrospective analysis was conducted of 6,613 suspected MVD cases (66 positive, 6,547 negative) reported between September 27 and December 20, 2024. Symptom prevalence and predictive value were assessed using multiple logistic regression models with L1 and L2 regularization to identify the most predictive symptoms. Models were validated using 5-fold cross-validation, with performance assessed through ROC analysis and standard accuracy metrics.

Results: Fever (78.8%), fatigue (63.6%), and headache (57.6%) were identified as the most common early symptoms, while hemorrhagic signs were rare (3.0%). The model achieved high accuracy (99.04%) and an AUC-ROC of 0.824, identifying fever, fatigue, nausea/vomiting, joint pain, and sore throat as key predictors.

Conclusion: Early symptom clusters, especially constitutional and gastrointestinal signs outperformed hemorrhagic symptoms for MVD detection. Findings challenge current case definitions, emphasizing the need for revised public health messaging and healthcare worker training. Integrating symptom-based models into surveillance could enhance detection, especially in resource-limited settings.

Clostridium butyricum (C. butyricum), a normal gut bacterium in humans, is commonly used as a probiotic. We described a 26-day-old premature neonate who was diagnosed with probiotic-related C. butyricum meningitis. Upon the admission, suppurative meningitis was considered based on cerebrospinal fluid (CSF) biochemical test and neuroimaging examination, and C. butyricum was subsequently identified by CSF metagenomic next-generation sequencing. Given the history of administrating living C. butyricum products before admission, probiotics-associated suppurative meningitis was considered a high possibility, leading to the confirmation of anti-infection treatment including vancomycin and meropenem. Following this therapy, the infant's CSF profiles demonstrated improvement. Additionally, further phylogenetic analysis confirmed the high homologous of C. butyricum from CSF with probiotics. This is the first report of C. butyricum infection in neonates, highlighting the importance for prudence in administrating probiotics for neonates, particularly in high-risk groups such as preterm infants, those with central venous catheters and intestinal diseases.

Introduction: We detected in October 2024 an abnormally high number of Chlamydia pneumoniae diagnoses through real-time surveillance of infections in Southeastern France, which followed significant increases in Mycoplasma pneumoniae and Bordetella pertussis diagnoses. Therefore, we retrospectively analyzed C. pneumoniae qPCR results performed on respiratory samples collected between 2018-2024 in our center and described these infections' features.

Methods: C. pneumoniae qPCR was part from a multiplex syndromic panel or an in-house simplex qPCR assay. Next-generation sequencing (NGS) was performed directly on available respiratory sample residues using Oxford Nanopore/Illumina technologies.

Results: We observed a 19-fold increase of C. pneumoniae qPCR-positivity in 2024 versus 2018-2023. Five (0.02%) of 25,255 respiratory samples were positive during 2018-2022, five (0.12%) of 4,294 in 2023, and 37 (0.64%) of 5,795 in 2024 (21 during September-October). Cases were mostly in children, then young adults. Highest incidence was in children between 11-15 years (8/1,075, 0.7%) and between 6-10 years (8/1,669, 0.5%). We obtained four (near) full-length C. pneumoniae genomes. They were of serotype ST16 and those the most closely-related with each other, apart from the six other ST16 genomes from GenBank, suggesting an epidemic spread in our area.

Conclusions: Present findings warrant a close monitoring of diagnoses of C. pneumoniae infections at the local and country scales, and to implement genomic surveillance and characterize drug resistance for diagnosed cases.

Objectives: Following the lifting of COVID-19 non-pharmaceutical interventions in China, respiratory infections surged, though the specific causes remained unclear. This study provided a comprehensive overview of the infectome in patients with acute febrile respiratory illness (AFRI) to inform disease surveillance.

Methods: Between March 2023 and February 2024, 1,163 oropharyngeal swabs from AFRI patients and 338 from healthy individuals were collected in Shenzhen. Meta-transcriptomic sequencing was employed for microbial analysis.

Results: We identified 14 viruses and 10 bacteria species known to cause human disease. Influenza virus, SARS-CoV-2, Streptococcus pneumoniae, and redondovirus were the most common, with a negative correlation between H3N2 and SARS-CoV-2. Notably, we detected certain enterovirus subtypes (e.g., Coxsackievirus A6 and Echovirus 30), previously overlooked pathogens (e.g., redondovirus), and rare pathogens like Streptococcus pseudopneumoniae. Comparisons revealed five pathogens showed significantly higher abundance in patients than in controls, despite no significant differences for others probably due to their limited number of positive pools. Seasonal shifts in microbial diversity and composition were observed, with climate factors like temperature and precipitation playing a role. Phylogenetic analysis revealed changes in genotype diversity and dominant pathogen lineages.

Conclusions: This study highlighted complex pathogen infections in AFRI patients following COVID-19 restrictions, demonstrating the value of meta-transcriptomics over PCR-based methods for more detailed pathogen surveillance.

Background: NAT2 polymorphisms affect isoniazid metabolism, but their effect on mortality among individuals with tuberculosis (TB) remains unclear.

Methods: This study used data from two TB cohorts (2005-2011, 2014-2020) and death certificate records in Thailand. Newly diagnosed Thai individuals treated with isoniazid-containing regimens were included. NAT2 genotypes-rapid, intermediate, and slow acetylator (RA, IA, SA)-were classified via haplotype inference. The primary outcome was 1-year all-cause mortality, while secondary outcomes included TB-related mortality, TB+respiratory disease-related mortality recorded in the vital registration system, and death as a TB treatment outcome. Adjusted hazard ratios (aHRs) relative to the IA type were estimated using stratified Cox proportional hazards models. Subgroup analyses targeted individuals with isoniazid-resistant TB and HIV infection.

Results: A total of 1,065 individuals (766 males; mean age=51 years) were analyzed. Individuals with RA had a 1.70-fold greater all-cause mortality risk (95% CI: 1.03-2.80) than IA. The aHRs for RA were 1.14 (0.43-3.03) for TB-related mortality, 1.59 (0.80-3.18) for TB+respiratory disease-related mortality, and 1.26 (0.67-2.14) for TB treatment outcome death. Among individuals with isoniazid-resistant TB, those with RA had a 4.68-fold (1.14-19.12) greater aHR for all-cause mortality.

Conclusion: The RA type is associated with increased 1-year all-cause mortality.

Objectives: Transmission routes of Helicobacter pylori (Hp) have been extensively studied, but many aspects remain unclear. This study explored the dynamics of multiplex Hp-serology within regular families during a 36-month prospective follow-up.

Methods: Altogether 329 families from the Finnish Family HPV (FFHPV)-study were subjected to sequential blood sampling and now tested also for six Hp-proteins; HP0010, HP0073, HP0547, HP0875, HP0887, and HP1564 using Multiplex serology assay.

Results: Hp-seropositivity, as defined by being seropositive to at least 3 of the 6 Hp proteins, was more common among the fathers (20%) than mothers (10%). After maternal antibody decay, only few children tested Hp-seropositive at later follow-up visits, indicating that acquisition of Hp-infection is practically non-existent (0.4% to 2.0%) at an early age. No evidence was found to support the person-to-person transmission of Hp in this cohort, as there was no correlation in Hp-seropositivity or antibody levels between the spouses and/or their offspring, and Hp-seropositive individuals did not seem to increase the risk of other family members to co-test Hp-seropositive.

Conclusion: Our results perfectly agree with a recently published register-linkage study from Finland, where Hp and Hp-related co-morbidity are predicted to disappear among the native Finns during the 21^st century.