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Molecular markers in diagnostics of fungi and fungal mycotoxins: A narrative review 分子标记在真菌和真菌毒素诊断中的应用综述。
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-28 DOI: 10.1016/j.jiph.2025.103073
Maryam Meskini , Mina Rezghi Rami , Rezvan Tavakoli , Masoumeh Salami
Fungi have dual impacts on human life, providing biotechnological benefits while posing health risks through mycotoxin production. These toxic secondary metabolites contaminate food and feed, causing serious health issues. This narrative review highlights detection and diagnostic strategies for mycotoxigenic fungi and their toxins. Literature from PubMed, Scopus, and Web of Science (2020–2024) was reviewed using keywords such as "mycotoxins," "fungal diagnostics," "biosensors," and "CRISPR." Analytical quantification relies mainly on liquid chromatography-mass spectrometry, while enzyme-linked immunosorbent assay and lateral flow assays enable rapid screening. Molecular tools, including polymerase chain reaction, microarrays, and next-generation sequencing, enhance the accuracy of fungal identification. Emerging platforms (CRISPR-based assays, biosensors, aptamers, and electronic noses) offer the potential for portable, real-time detection. Key challenges involve reducing assay costs, improving sensitivity in complex matrices, and harmonizing international standards. Integrating molecular and analytical approaches can strengthen early-warning systems to limit the health and economic burdens of mycotoxin contamination.
真菌对人类生活具有双重影响,一方面提供生物技术上的益处,另一方面通过产生真菌毒素对健康构成威胁。这些有毒的次生代谢物污染食品和饲料,造成严重的健康问题。这篇叙述性综述强调了产霉菌毒素真菌及其毒素的检测和诊断策略。使用“真菌毒素”、“真菌诊断”、“生物传感器”和“CRISPR”等关键词对PubMed、Scopus和Web of Science(2020-2024)的文献进行了综述。分析定量主要依靠液相色谱-质谱法,而酶联免疫吸附测定和侧流测定可以快速筛选。分子工具,包括聚合酶链反应,微阵列和下一代测序,提高了真菌鉴定的准确性。新兴平台(基于crispr的检测、生物传感器、适体和电子鼻)提供了便携式、实时检测的潜力。主要挑战包括降低分析成本,提高对复杂基质的敏感性,以及协调国际标准。结合分子和分析方法可以加强早期预警系统,以限制霉菌毒素污染造成的健康和经济负担。
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引用次数: 0
Seroprevalence of four zoonotic viral diseases in camels in Qatar 卡塔尔骆驼四种人畜共患病毒性疾病的血清患病率
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-28 DOI: 10.1016/j.jiph.2025.103074
AlMaha A. AlSaiari , Nada M. Al-Karbi , Maria K. Smatti , Ahmed Gawish , Nahla O. Eltai , Asmaa A. Althani , Hadi M. Yassine

Background

Understanding the dynamics of zoonotic diseases is integral to the One Health approach, as it guides strategies to mitigate the impact of infections on both animal and human health. In Qatar, the circulation of many zoonotic viral infections among animals remains unknown.

Aim

This study aimed to investigate the seroprevalence of four zoonotic viral diseases in camels in Qatar: The Middle East respiratory syndrome coronavirus (MERS-CoV), in addition to three arboviruses (arthropod-borne viruses): [West Nile virus (WNV), Crimean-Congo hemorrhagic fever virus (CCHFV), and Rift Valley fever virus (RVFV)].

Methods

A total of 186 camel samples were collected from 23 farms at six municipalities in Qatar between 2019 and 2021. Specific anti-virus IgG or IgM antibodies were detected using commercial enzyme-linked immunosorbent assay (ELISA) kits.

Results

Overall, we found a high seroprevalence of MERS-CoV IgG in camels (95.1 %), followed by CCHFV IgG (56 %) and WNV IgG (23.3 %). On the other hand, the seropositivity of anti-RVFV IgG was 1.7 %, and none of the tested samples exhibited RVFV-reactive IgM antibodies. Moreover, 97 (52.2 %) camel samples tested positive for at least MERS-CoV- and CCHFV-reactive antibodies. Seroprevalences were comparable irrespective of the animals’ sex. Although MERS-CoV exposure was high in all age groups (>92 %), a statistically significant difference in the anti-MERS-CoV IgG ELISA OD values was observed between samples collected from camels aged 10 years or above compared to those below the age of 5 years (p = 0.018).

Conclusion

Our study provided evidence of a relatively high ratio of exposure to MERS-CoV, CCHFV, and WNV in camels in Qatar. To better understand these zoonotic viral diseases, additional studies involving larger animal populations, investigating vector dynamics, and monitoring livestock movements in and out of the country are imperative.
了解人畜共患疾病的动态是“同一个健康”方法不可或缺的一部分,因为它指导减轻感染对动物和人类健康影响的战略。在卡塔尔,许多人畜共患病毒感染在动物之间的传播情况仍然未知。目的调查卡塔尔骆驼中4种人畜共患病毒性疾病的血清患病率:中东呼吸综合征冠状病毒(MERS-CoV),以及3种虫媒病毒(节肢动物传播的病毒):西尼罗病毒(WNV)、克里米亚-刚果出血热病毒(CCHFV)和裂谷热病毒(RVFV)。方法2019 - 2021年在卡塔尔6个城市的23个农场采集了186只骆驼样本。采用商用酶联免疫吸附试验(ELISA)试剂盒检测特异性抗病毒IgG或IgM抗体。结果骆驼血清MERS-CoV IgG阳性率最高(95.1% %),其次是CCHFV IgG(56% %)和WNV IgG(23.3% %)。另一方面,抗裂谷病毒IgG血清阳性率为1.7 %,所有检测样本均未出现裂谷病毒反应性IgM抗体。此外,97份(52.2% %)骆驼样本至少检测出MERS-CoV和cchfv反应性抗体阳性。不论动物的性别,血清患病率都具有可比性。尽管所有年龄组的MERS-CoV暴露率都很高(>92 %),但10岁及以上的骆驼与5岁以下的骆驼相比,抗MERS-CoV IgG ELISA OD值有统计学差异(p = 0.018)。结论本研究为卡塔尔骆驼暴露于MERS-CoV、CCHFV和WNV的比例较高提供了证据。为了更好地了解这些人畜共患病毒性疾病,必须开展涉及更大动物种群的进一步研究,调查病媒动态,并监测牲畜进出该国的情况。
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引用次数: 0
Prevalence and genetic characteristics of Staphylococcus capitis proto-NRCS-A clone among colonizing isolates from healthy individuals in Japan 猪头葡萄球菌原nrcs - a在日本健康人群定殖分离株中的流行及遗传特征
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-27 DOI: 10.1016/j.jiph.2025.103071
Mina Hirose , Meiji Soe Aung , Yukito Hirose , Yasuhiro Nakanishi , Taisei Kato , Akihiro Ichimura , Yoshihito Kurashige , Sayaka Sakakibara , Erika Minowa-Suzuki , Masato Saitoh , Noriko Urushibara , Mitsuyo Kawaguchiya , Nobuhide Ohashi , Nobumichi Kobayashi

Objectives

S. capitis is among the coagulase-negative staphylococci (CoNS) and a commensal bacterium in humans. However, a virulent clone designated NRCS-A has been reported to be responsible for outbreaks of neonatal sepsis, primarily in Europe. This clone harbors virulence factors nsr and tarJ, and carries a type V SCCmec, showing multiple antimicrobial resistance. This study explored the prevalence of the (proto-)NRCS-A clone in healthy individuals and their genetic characteristics in Japan.

Methods

Staphylococci colonizing on the hand skin and the oral cavity of healthy individuals were isolated and analyzed for the species/subspecies by sequencing of 16S rRNA and arcC. The presence of virulence factors and antimicrobial resistance-associated genes were detected by PCR and sequencing. S. capitis isolates were genetically classified by double-locus (arcC-rpoB) sequence typing and peptide profile of PSMβ.

Results

Among 221 isolates of CoNS (19 species) recovered from 444 healthy adults, 82 isolates were identified as S. capitis. Virulence factors associated with the NRCS-A clone, i.e., nsr, tarJ, and ebh were detected in 29 %, 11 %, and 51 % of isolates, respectively, while mecA/SCCmec V was positive in only one isolate harboring solely tarJ. arcC and rpoB were classified into 14 and 10 allelic types, respectively. PSMβ consisted of 3, 4, or 6 units of 44 amino acid-peptide, forming eight different profiles. Both virulence factors nsr and tarJ were detected in 5 isolates (6 %), among which two isolates had the same PSMβ profile and arcC-rpoB types as those of the NRCS-A clone prototype strain CR01. The mecA-positive isolate was classified into the same arcC-rpoB lineage as that of CR01.

Conclusion

The present study revealed that SCCmec-negative S. capitis with nsr/tarJ (proto-NRCS-A clone) is distributed at low prevalence to healthy individuals in Japan. These isolates belonged to arcC-rpoB lineages close to that of the NRCS-A clone.
目的:猪头链球菌是凝固酶阴性葡萄球菌(con)之一,也是人类的一种共生细菌。然而,一种命名为NRCS-A的毒性克隆被报道为新生儿败血症暴发的罪魁祸首,主要发生在欧洲。该克隆携带毒力因子nsr和tarJ,并携带V型SCCmec,表现出多重抗微生物药物耐药性。本研究探讨了日本健康人群中(原)NRCS-A克隆的流行情况及其遗传特征。方法:分离健康人群手部皮肤和口腔定植的葡萄球菌,通过16S rRNA和arcC序列分析其种/亚种。采用PCR和测序方法检测毒力因子和耐药相关基因的存在。通过双位点(arcC-rpoB)序列分型和PSMβ肽谱对猪头链球菌分离株进行遗传分类。结果:从444例健康成人中分离得到221株(19种),其中82株为头孢球菌。与NRCS-A克隆相关的毒力因子,即nsr, tarJ和ebh分别在29% %,11% %和51% %的分离株中检测到,而仅在一个单独携带tarJ的分离株中检测到mecA/SCCmec V阳性。arcC和rpoB分别被划分为14个和10个等位基因类型。PSMβ由3个、4个或6个单位的44个氨基酸肽组成,形成8个不同的谱。5株(6 %)分离株均检测到毒力因子nsr和tarJ,其中2株与NRCS-A克隆原型菌株CR01具有相同的PSMβ谱和arcC-rpoB型。meca阳性分离物与CR01属同一arcC-rpoB谱系。结论:本研究显示sccmec阴性头链球菌伴nsr/tarJ(原nrcs - a克隆)在日本健康人群中呈低患病率分布。这些分离株属于与NRCS-A克隆接近的arcC-rpoB谱系。
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引用次数: 0
Regulatory mechanism of the oprM gene in colistin resistance of acinetobacter baumannii oprM基因对鲍曼不动杆菌耐粘菌素的调控机制
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-24 DOI: 10.1016/j.jiph.2025.103068
Ling Wang , Yuting Wang , Huihuang Xu , Wenjie Li , Junshan Ruan

Background

Colistin resistance in Acinetobacter baumannii (AB) is a serious clinical concern. This study aimed to identify resistance-related genes and assess their effects on resistance, growth, and pathogenicity.

Methods

Bioinformatics combined with machine learning identified candidate genes, validated by quantitative real-time PCR. The oprM gene was deleted in a colistin-resistant strain (COL-R) to obtain COL-R-ΔoprM. Minimum inhibitory concentration, growth, and biofilm formation were measured. A mouse lung infection model compared bacterial burden, inflammatory cytokines, and histopathology among the ATCC standard strain, COL-R, and COL-R-ΔoprM, with or without colistin.

Results

The oprM gene and F3P16_RS16375 were identified as candidate genes, with oprM expression markedly upregulated in induced COL-R. Deletion of oprM reduced the colistin MIC, and impaired biofilm formation. In vivo, COL-R-ΔoprM showed lower lung bacterial loads than COL-R strains. Compared with the corresponding infection group, the COL-R-∆oprM + COL group significantly reduced the expression levels of TNF-α, IL-1β, and IL-6, improved lung tissue damage, and effectively reduced the bacterial load in lung tissue (P < 0.01), while there was no significant difference in all aspects of the COL-R + COL group (P > 0.05).

Conclusion

The oprM gene is a crucial determinant of colistin resistance in AB. Its deletion restores colistin susceptibility, impairs biofilm formation, and attenuates virulence. Targeting oprM may provide a promising approach for treating colistin-resistant AB infections.
鲍曼不动杆菌(AB)的粘菌素耐药性是一个严重的临床问题。本研究旨在鉴定抗性相关基因,并评估其对抗性、生长和致病性的影响。方法生物信息学结合机器学习技术鉴定候选基因,采用实时荧光定量PCR技术进行验证。在粘菌素耐药菌株(COL-R)中删除oprM基因,得到COL-R-ΔoprM。测定最低抑菌浓度、生长和生物膜形成。小鼠肺部感染模型比较了使用或不使用粘菌素的ATCC标准菌株COL-R和COL-R-ΔoprM之间的细菌负荷、炎症细胞因子和组织病理学。结果oprM基因和F3P16_RS16375被鉴定为候选基因,在诱导的COL-R中,oprM的表达显著上调。oprM的缺失降低了粘菌素MIC,并破坏了生物膜的形成。在体内,COL-R-ΔoprM的肺部细菌负荷低于COL-R菌株。与相应感染组比较,COL- r -∆oprM + COL组显著降低TNF-α、IL-1β、IL-6表达水平,改善肺组织损伤,有效降低肺组织细菌负荷(P <; 0.01),而COL- r + COL组各方面差异无统计学意义(P >; 0.05)。结论oprM基因是AB耐粘菌素的重要决定因素,其缺失可恢复粘菌素敏感性,抑制生物膜形成,降低毒力。靶向oprM可能为治疗耐粘菌素AB感染提供了一种有希望的方法。
{"title":"Regulatory mechanism of the oprM gene in colistin resistance of acinetobacter baumannii","authors":"Ling Wang ,&nbsp;Yuting Wang ,&nbsp;Huihuang Xu ,&nbsp;Wenjie Li ,&nbsp;Junshan Ruan","doi":"10.1016/j.jiph.2025.103068","DOIUrl":"10.1016/j.jiph.2025.103068","url":null,"abstract":"<div><h3>Background</h3><div>Colistin resistance in Acinetobacter baumannii (AB) is a serious clinical concern. This study aimed to identify resistance-related genes and assess their effects on resistance, growth, and pathogenicity.</div></div><div><h3>Methods</h3><div>Bioinformatics combined with machine learning identified candidate genes, validated by quantitative real-time PCR. The oprM gene was deleted in a colistin-resistant strain (COL-R) to obtain COL-R-ΔoprM. Minimum inhibitory concentration, growth, and biofilm formation were measured. A mouse lung infection model compared bacterial burden, inflammatory cytokines, and histopathology among the ATCC standard strain, COL-R, and COL-R-ΔoprM, with or without colistin.</div></div><div><h3>Results</h3><div>The oprM gene and F3P16_RS16375 were identified as candidate genes, with oprM expression markedly upregulated in induced COL-R. Deletion of oprM reduced the colistin MIC, and impaired biofilm formation. In vivo, COL-R-ΔoprM showed lower lung bacterial loads than COL-R strains. Compared with the corresponding infection group, the COL-R-∆oprM + COL group significantly reduced the expression levels of TNF-α, IL-1β, and IL-6, improved lung tissue damage, and effectively reduced the bacterial load in lung tissue (P &lt; 0.01), while there was no significant difference in all aspects of the COL-R + COL group (P &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>The oprM gene is a crucial determinant of colistin resistance in AB. Its deletion restores colistin susceptibility, impairs biofilm formation, and attenuates virulence. Targeting oprM may provide a promising approach for treating colistin-resistant AB infections.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103068"},"PeriodicalIF":4.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Comparing definitions of SARS-CoV-2 infection in a prospective household transmission study 一项前瞻性家庭传播研究中SARS-CoV-2感染定义的比较
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-22 DOI: 10.1016/j.jiph.2025.103069
Jonas Frost , Bianca Klee , Sophie Diexer , Kristin Maria Meyer-Schlinkmann , Cornelia Gottschick , Jonas Rosendahl , Michael Gekle , Stefan Moritz , Simone Hettmer , Jessica I. Hoell , Irene Moor , Thomas Frese , Mascha Binder , Christine Dierks , Rafael Mikolajczyk

Background

Identifying SARS-CoV-2 infections in field studies, especially if they are asymptomatic or reinfections, is challenging. This study aims to compare definitions of an infection and establish an approach to detect reinfections serologically, relying on titre increase.

Methods

In a household transmission study in autumn/winter 2022, we collected information on symptoms and two serological samples in a timespan of six to eight weeks from 389 participants of the German digital cohort DigiHero. Blood samples were drawn using dried blood spot cards and analysed in regard to the SARS-CoV-2 S and N antibody. We calculated secondary attack rates (SARs) using three definitions of infection from previous literature, based on reported symptoms or seroconversion, and two approaches accounting for reinfection in serological testing.

Results

SARs differed substantially between definitions. High initial seroprevalence in the study population led to underestimation of the SAR by over 20 % when using seroconversion compared to approaches accounting for reinfections. Symptom-based definitions resulted in misclassification likely due to infections with other pathogens and by disregarding asymptomatic cases.

Conclusions

This methodological study shows that relying on seroconversion is not adequate in high sero-prevalence settings and symptom-based approaches disregard asymptomatic cases. Approaches accounting for substantial titre increases between two antibody measurements reliably identified infections regardless of seroconversion and symptoms in a longitudinal serological assessment. This method could be useful for other pathogens, where asymptomatic disease and reinfections are common.
在实地研究中识别SARS-CoV-2感染,特别是如果他们无症状或再次感染,是具有挑战性的。本研究的目的是比较感染的定义,并建立一种方法来检测再感染血清学,依靠滴度增加。方法在2022年秋冬季的一项家庭传播研究中,我们收集了来自德国数字队列DigiHero的389名参与者的症状信息和两份血清学样本,时间跨度为6至8周。使用干血抽血卡抽取血样,并对SARS-CoV-2 S和N抗体进行分析。我们使用先前文献中关于感染的三种定义(基于报告的症状或血清转换)和血清学检测中考虑再感染的两种方法来计算继发发病率(SARs)。结果不同定义的sar差异很大。与考虑再感染的方法相比,研究人群中较高的初始血清阳性率导致血清转换对SAR的低估超过20% %。基于症状的定义可能由于感染其他病原体和忽视无症状病例而导致错误分类。结论:该方法学研究表明,在高血清患病率的情况下,依赖血清转换是不够的,基于症状的方法忽视了无症状病例。在纵向血清学评估中,无论血清转化和症状如何,在两次抗体测量之间显著滴度增加的方法都可靠地确定了感染。这种方法可能对其他病原体有用,其中无症状疾病和再感染是常见的。
{"title":"Comparing definitions of SARS-CoV-2 infection in a prospective household transmission study","authors":"Jonas Frost ,&nbsp;Bianca Klee ,&nbsp;Sophie Diexer ,&nbsp;Kristin Maria Meyer-Schlinkmann ,&nbsp;Cornelia Gottschick ,&nbsp;Jonas Rosendahl ,&nbsp;Michael Gekle ,&nbsp;Stefan Moritz ,&nbsp;Simone Hettmer ,&nbsp;Jessica I. Hoell ,&nbsp;Irene Moor ,&nbsp;Thomas Frese ,&nbsp;Mascha Binder ,&nbsp;Christine Dierks ,&nbsp;Rafael Mikolajczyk","doi":"10.1016/j.jiph.2025.103069","DOIUrl":"10.1016/j.jiph.2025.103069","url":null,"abstract":"<div><h3>Background</h3><div>Identifying SARS-CoV-2 infections in field studies, especially if they are asymptomatic or reinfections, is challenging. This study aims to compare definitions of an infection and establish an approach to detect reinfections serologically, relying on titre increase.</div></div><div><h3>Methods</h3><div>In a household transmission study in autumn/winter 2022, we collected information on symptoms and two serological samples in a timespan of six to eight weeks from 389 participants of the German digital cohort DigiHero. Blood samples were drawn using dried blood spot cards and analysed in regard to the SARS-CoV-2 S and N antibody. We calculated secondary attack rates (SARs) using three definitions of infection from previous literature, based on reported symptoms or seroconversion, and two approaches accounting for reinfection in serological testing.</div></div><div><h3>Results</h3><div>SARs differed substantially between definitions. High initial seroprevalence in the study population led to underestimation of the SAR by over 20 % when using seroconversion compared to approaches accounting for reinfections. Symptom-based definitions resulted in misclassification likely due to infections with other pathogens and by disregarding asymptomatic cases.</div></div><div><h3>Conclusions</h3><div>This methodological study shows that relying on seroconversion is not adequate in high sero-prevalence settings and symptom-based approaches disregard asymptomatic cases. Approaches accounting for substantial titre increases between two antibody measurements reliably identified infections regardless of seroconversion and symptoms in a longitudinal serological assessment. This method could be useful for other pathogens, where asymptomatic disease and reinfections are common.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103069"},"PeriodicalIF":4.0,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Nationwide longitudinal evaluation of a machine learning approach for enhanced interpretation of Xpert MTB/RIF ultra rifampicin-resistance results in low bacterial load tuberculosis specimens 在全国范围内对机器学习方法进行纵向评估,以增强对Xpert MTB/RIF超利福平耐药性的解释,从而产生低细菌负荷结核病标本
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-21 DOI: 10.1016/j.jiph.2025.103064
Tai-Han Lin , Hsing-Yi Chung , Ming-Jr Jian , Chih-Kai Chang , Yun-Wen Lai , Cherng-Lih Perng , Feng-Yee Chang , Yuan-Hao Chen , Hung-Sheng Shang

Background

The World Health Organization (WHO) has identified tuberculosis (TB) as the leading cause of death from a single infectious agent. False-positive rifampicin (RIF) resistance results from the Xpert MTB/RIF Ultra assay are common in TB patients with low bacterial loads, especially among HIV-coinfected individuals. Hence, to distinguish genuine RIF resistance from false-positive results, this study developed and validated an artificial intelligence clinical decision support system (AI-CDSS).

Methods

Between January 2021 and March 2025, Taiwan's national TB reference laboratory received 10,353 respiratory specimens nationwide, identifying 2443 MTB-positive samples. The specimens were subjected to Xpert MTB/RIF Ultra testing and RIF resistance was confirmed using GenoType MTBDRplus assays. Molecular features, including cycle threshold (Ct) values, melting temperatures (Tm), and fluorescence intensities of rpoB probes, were analyzed. Three machine learning algorithms: random forest, gradient boosting classifier, and light gradient boosting machine (LGBM) were trained and validated.

Results

Ultra initially reported RIF resistance in 174 samples (7.1 %), with the highest false-positive rate of 12.2 % observed in samples with very low bacterial loads. LGBM demonstrated superior diagnostic performance (AUC = 0.99, sensitivity = 0.97, specificity = 0.99, and F1-score = 0.98). Key predictive features included Tm and fluorescence intensity, particularly in the rpoB3 region. Implementing the AI-CDSS significantly improved accuracy and reduced diagnostic turnaround times.

Conclusions

By leveraging the LGBM model, AI-CDSS effectively distinguished true RIF resistance from false-positive Xpert Ultra results, particularly among patients with low MTB bacterial loads. This approach enhances clinical decision making, optimizes treatment initiation, and conserves vital multidrug-resistant TB resources.
背景:世界卫生组织(WHO)已经确定结核病(TB)是由单一传染病引起的主要死亡原因。Xpert MTB/RIF Ultra检测的利福平(RIF)耐药性假阳性结果在细菌载量低的结核病患者中很常见,特别是在hiv合并感染者中。因此,为了区分真正的RIF耐药性和假阳性结果,本研究开发并验证了人工智能临床决策支持系统(AI-CDSS)。​采用Xpert MTB/RIF Ultra检测,采用基因型MTBDRplus检测证实对RIF耐药。分析了rpoB探针的分子特征,包括循环阈值(Ct)值、熔化温度(Tm)和荧光强度。对随机森林、梯度增强分类器和光梯度增强机(LGBM)三种机器学习算法进行了训练和验证。结果在174份样品中(7.1 %)初步报告了RIF耐药,在细菌负荷极低的样品中,假阳性率最高,为12.2 %。LGBM表现出优越的诊断性能(AUC = 0.99,敏感性= 0.97,特异性= 0.99,F1-score = 0.98)。关键的预测特征包括Tm和荧光强度,特别是在rpoB3区域。实施AI-CDSS可显著提高准确性并缩短诊断周转时间。通过利用LGBM模型,AI-CDSS有效区分了真正的RIF耐药性和假阳性的Xpert Ultra结果,特别是在低MTB细菌载量的患者中。这种方法加强了临床决策,优化了治疗启动,并保存了至关重要的耐多药结核病资源。
{"title":"Nationwide longitudinal evaluation of a machine learning approach for enhanced interpretation of Xpert MTB/RIF ultra rifampicin-resistance results in low bacterial load tuberculosis specimens","authors":"Tai-Han Lin ,&nbsp;Hsing-Yi Chung ,&nbsp;Ming-Jr Jian ,&nbsp;Chih-Kai Chang ,&nbsp;Yun-Wen Lai ,&nbsp;Cherng-Lih Perng ,&nbsp;Feng-Yee Chang ,&nbsp;Yuan-Hao Chen ,&nbsp;Hung-Sheng Shang","doi":"10.1016/j.jiph.2025.103064","DOIUrl":"10.1016/j.jiph.2025.103064","url":null,"abstract":"<div><h3>Background</h3><div>The World Health Organization (WHO) has identified tuberculosis (TB) as the leading cause of death from a single infectious agent. False-positive rifampicin (RIF) resistance results from the Xpert MTB/RIF Ultra assay are common in TB patients with low bacterial loads, especially among HIV-coinfected individuals. Hence, to distinguish genuine RIF resistance from false-positive results, this study developed and validated an artificial intelligence clinical decision support system (AI-CDSS).</div></div><div><h3>Methods</h3><div>Between January 2021 and March 2025, Taiwan's national TB reference laboratory received 10,353 respiratory specimens nationwide, identifying 2443 MTB-positive samples. The specimens were subjected to Xpert MTB/RIF Ultra testing and RIF resistance was confirmed using GenoType MTBDRplus assays. Molecular features, including cycle threshold (Ct) values, melting temperatures (Tm), and fluorescence intensities of rpoB probes, were analyzed. Three machine learning algorithms: random forest, gradient boosting classifier, and light gradient boosting machine (LGBM) were trained and validated.</div></div><div><h3>Results</h3><div>Ultra initially reported RIF resistance in 174 samples (7.1 %), with the highest false-positive rate of 12.2 % observed in samples with very low bacterial loads. LGBM demonstrated superior diagnostic performance (AUC = 0.99, sensitivity = 0.97, specificity = 0.99, and F1-score = 0.98). Key predictive features included Tm and fluorescence intensity, particularly in the rpoB3 region. Implementing the AI-CDSS significantly improved accuracy and reduced diagnostic turnaround times.</div></div><div><h3>Conclusions</h3><div>By leveraging the LGBM model, AI-CDSS effectively distinguished true RIF resistance from false-positive Xpert Ultra results, particularly among patients with low MTB bacterial loads. This approach enhances clinical decision making, optimizes treatment initiation, and conserves vital multidrug-resistant TB resources.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103064"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
RSV-associated hospitalizations in Bangladeshi children under five: Unveiling the disease burden 孟加拉国五岁以下儿童rsv相关住院:揭示疾病负担
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-21 DOI: 10.1016/j.jiph.2025.103067
Mst. Noorjahan Begum , Yeasir Karim , Sabik Khair , Sumaiya Binte Hannan , Selim Reza Tony , Nure Sharaf Nower Samia , Mohammad Jubair , Shaheen Alam , Mohammad Hridoy Patwary , Anisuddin Ahmed , Md Ariful Islam , Tanzir Ahmed Shuvo , Manjur Hossain Khan Jony , Tahmina Shirin , Fahmida Chowdhury , Firdausi Qadri , Mustafizur Rahman

Objectives

Respiratory Syncytial Virus (RSV) is a leading cause of acute lower respiratory tract infections among children under five years of age globally. Despite its significant health burden, data on RSV infection in this age group in Bangladesh are limited. This study aims to estimate the prevalence of RSV among hospitalized Bangladeshi children under five years of age and to explore its distribution across key demographic factors, including age, sex, and geographic region.

Methods

We designed the study based on the hospital-based influenza surveillance conducted by icddr,b, enrolling children who presented with severe acute respiratory infections (SARI) or influenza-like illness (ILI) symptoms. Both nasopharyngeal and oropharyngeal swabs from each participant were collected and subjected to real-time RT-PCR for RSV detection. Data were analyzed using descriptive statistics, chi-square tests and multiple logistic regression.

Results

From October 2022 to December 2024, we enrolled 8203 patients with SARI and ILI, of whom 2758 tested positive for RSV. RSV was detected at a significantly higher proportion among SARI cases 2583 (36 %), compared to ILI cases 175 (16 %) (p < 0.001). Infants under six months exhibited the highest infection proportion (44 %), with prevalence decreasing with age. RSV activity in Bangladesh begins in the southern districts in August and peaks nationwide between October and December.

Conclusions

This study highlights a significant RSV burden among children less than six months of age with SARI. These findings emphasize the need for targeted age-specific control measures to reduce hospitalization.
呼吸道合胞病毒(RSV)是全球5岁以下儿童急性下呼吸道感染的主要原因。尽管存在严重的健康负担,但孟加拉国这一年龄组RSV感染的数据有限。本研究旨在估计孟加拉国5岁以下住院儿童RSV患病率,并探讨其在关键人口因素(包括年龄、性别和地理区域)中的分布。方法本研究是基于icddr,b开展的以医院为基础的流感监测,纳入出现严重急性呼吸道感染(SARI)或流感样疾病(ILI)症状的儿童。收集每位参与者的鼻咽拭子和口咽拭子,进行实时RT-PCR检测RSV。数据分析采用描述性统计、卡方检验和多元逻辑回归。结果从2022年10月至2024年12月,我们纳入了8203例SARI和ILI患者,其中2758例RSV检测呈阳性。在急性呼吸道感染病例中,RSV的检出率为2583例(36 %),显著高于ILI病例175例(16 %)(p <; 0.001)。6个月以下婴儿感染率最高(44. %),感染率随年龄增长而下降。孟加拉国的呼吸道合胞病毒活动于8月在南部地区开始,10月至12月在全国达到高峰。结论:本研究强调了呼吸道合胞病毒在6个月以下严重急性呼吸道感染儿童中的显著负担。这些发现强调需要针对特定年龄的控制措施来减少住院。
{"title":"RSV-associated hospitalizations in Bangladeshi children under five: Unveiling the disease burden","authors":"Mst. Noorjahan Begum ,&nbsp;Yeasir Karim ,&nbsp;Sabik Khair ,&nbsp;Sumaiya Binte Hannan ,&nbsp;Selim Reza Tony ,&nbsp;Nure Sharaf Nower Samia ,&nbsp;Mohammad Jubair ,&nbsp;Shaheen Alam ,&nbsp;Mohammad Hridoy Patwary ,&nbsp;Anisuddin Ahmed ,&nbsp;Md Ariful Islam ,&nbsp;Tanzir Ahmed Shuvo ,&nbsp;Manjur Hossain Khan Jony ,&nbsp;Tahmina Shirin ,&nbsp;Fahmida Chowdhury ,&nbsp;Firdausi Qadri ,&nbsp;Mustafizur Rahman","doi":"10.1016/j.jiph.2025.103067","DOIUrl":"10.1016/j.jiph.2025.103067","url":null,"abstract":"<div><h3>Objectives</h3><div>Respiratory Syncytial Virus (RSV) is a leading cause of acute lower respiratory tract infections among children under five years of age globally. Despite its significant health burden, data on RSV infection in this age group in Bangladesh are limited. This study aims to estimate the prevalence of RSV among hospitalized Bangladeshi children under five years of age and to explore its distribution across key demographic factors, including age, sex, and geographic region.</div></div><div><h3>Methods</h3><div>We designed the study based on the hospital-based influenza surveillance conducted by icddr,b, enrolling children who presented with severe acute respiratory infections (SARI) or influenza-like illness (ILI) symptoms. Both nasopharyngeal and oropharyngeal swabs from each participant were collected and subjected to real-time RT-PCR for RSV detection. Data were analyzed using descriptive statistics, chi-square tests and multiple logistic regression.</div></div><div><h3>Results</h3><div>From October 2022 to December 2024, we enrolled 8203 patients with SARI and ILI, of whom 2758 tested positive for RSV. RSV was detected at a significantly higher proportion among SARI cases 2583 (36 %), compared to ILI cases 175 (16 %) (p &lt; 0.001). Infants under six months exhibited the highest infection proportion (44 %), with prevalence decreasing with age. RSV activity in Bangladesh begins in the southern districts in August and peaks nationwide between October and December.</div></div><div><h3>Conclusions</h3><div>This study highlights a significant RSV burden among children less than six months of age with SARI. These findings emphasize the need for targeted age-specific control measures to reduce hospitalization.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103067"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Malignant pertussis in infants: 4 new cases in French Guiana 婴儿恶性百日咳:法属圭亚那4例新病例
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-21 DOI: 10.1016/j.jiph.2025.103065
Cédric Ngila Lubunu , Christelle Samou-Fontcho , Urbain Agbessy Awanou , Narcisse Elenga
Malignant pertussis is a severe form of pertussis characterized by respiratory distress, polyvisceral failure, and marked hyperlymphocytosis. It typically presents with profound leukocytosis, pulmonary hypertension, and respiratory failure. We report four cases of malignant pertussis in young infants. One patient underwent exchange transfusion. The case fatality rate was 50 %. Preventing these severe and often fatal cases—associated with high mortality and significant intensive care costs—relies primarily on vaccination. Immunization should be ensured for all infants and extended to adults at risk of transmitting the infection to unimmunized infants.
恶性百日咳是一种严重的百日咳,以呼吸窘迫、多脏器功能衰竭和明显的淋巴细胞增多为特征。典型表现为严重的白细胞增多、肺动脉高压和呼吸衰竭。我们报告四例恶性百日咳在年轻的婴儿。一名患者接受了换血。病死率为50% %。预防这些与高死亡率和大量重症监护费用相关的严重且往往致命的病例主要依靠疫苗接种。应确保对所有婴儿进行免疫接种,并扩大到有将感染传播给未接种疫苗的婴儿风险的成年人。
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引用次数: 0
Association between early dexamethasone administration and mortality in SARS-CoV-2 infection: A cohort study 早期地塞米松给药与SARS-CoV-2感染死亡率的关系:一项队列研究
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-21 DOI: 10.1016/j.jiph.2025.103066
Renata Báez-Saldaña , Ernesto Murillo-Trejo , Lina Barranco-Garduño , Juan Carlos Neri-Salvador , Thalia Jacobo-Vargas , Ana Laura Bazany-Rivero , Uriel Rumbo-Nava

Background

Dexamethasone, or equivalent corticosteroids, are recommended for patients with SARS-CoV-2 pneumonia, regardless of respiratory failure status. However, the effects of giving dexamethasone within the first seven days after symptom onset—during the viremic phase—have not been sufficiently studied in clinical trials or observational studies. As a result, the best timing for starting corticosteroids remains uncertain. This study aimed to evaluate the effect of dexamethasone administration within seven days of symptom onset from SARS-CoV-2 infection on mortality and the need for invasive mechanical ventilation among hospitalized patients with severe pneumonia.

Methods

This cohort study included hospitalized patients aged 18 years or older with severe SARS-CoV-2 pneumonia. The exposure was dexamethasone use before hospitalization, and the outcome measures included in-hospital mortality and invasive mechanical ventilation. Patients were monitored until discharge or death in the hospital. Logistic regression was used to evaluate the association between pre-hospitalization dexamethasone administration and mortality.

Results

We enrolled 234 patients. The median age was 56 years, and 70.5 % were men. Before hospitalization, dexamethasone was administered to 125 (53 %) patients within the first seven days of symptom onset, which was linked to mortality (OR [95 % CI] 3.58 [1.51–8.48]) and the need for invasive mechanical ventilation (OR [95 % CI] 2.59 [1.46–4.59]), after adjusting for factors such as, sex, Charlson comorbidity index ≥ 3, neutrophil count over 8500 cells/mm^3, and albumin below 3 g/dL.

Conclusion

Administering dexamethasone within the first seven days of SARS-CoV-2 infection may be associated with a higher risk of death in hospitalized patients with severe pneumonia. These findings emphasize the importance of carefully timing corticosteroid treatment in COVID-19 patients.
背景:无论呼吸衰竭状态如何,建议对SARS-CoV-2肺炎患者使用地塞米松或等效皮质类固醇。然而,在症状出现后的头7天内给予地塞米松的效果——在病毒血症阶段——尚未在临床试验或观察性研究中得到充分研究。因此,开始使用皮质类固醇的最佳时机仍不确定。本研究旨在评估SARS-CoV-2感染症状出现后7天内给予地塞米松对重症肺炎住院患者死亡率和有创机械通气需求的影响。方法本队列研究纳入18岁及以上住院的重症SARS-CoV-2肺炎患者。暴露于住院前使用地塞米松,结果测量包括住院死亡率和有创机械通气。对患者进行监测,直至出院或在医院死亡。采用Logistic回归评价住院前地塞米松给药与死亡率之间的关系。结果共纳入234例患者。中位年龄为56岁,70.5% %为男性。住院前,125例(53 %)患者在症状出现的前7天内给予地塞米松治疗,在调整性别、Charlson合并症指数≥ 3、中性粒细胞计数超过8500个/mm^3、白蛋白低于3 g/dL等因素后,与死亡率(OR[95 % CI] 3.58[1.51-8.48])和需要有创伤机械通气(OR[95 % CI] 2.59[1.46-4.59])相关。结论重症肺炎住院患者感染SARS-CoV-2后7天内给予地塞米松治疗可能与死亡风险增高有关。这些发现强调了在COVID-19患者中仔细选择皮质类固醇治疗时机的重要性。
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引用次数: 0
Prevalent fungal pathogens and antifungal resistance in Lebanon: A scoping review 黎巴嫩流行的真菌病原体和抗真菌耐药性:范围综述
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-11-20 DOI: 10.1016/j.jiph.2025.103062
Yara Khachab , Majd Bou Ghader , Vera Tahesh , Racha Khoumassi , Elie Salem Sokhn
Fungal infections are an increasing public health concern in Lebanon, particularly among immunocompromised individuals. Common pathogens include Candida albicans, C. glabrata (Nakaseomyces glabrata), C. parapsilosis, C. tropicalis, and emerging C. krusei (Pichia Kudriavzevii), alongside dermatophytes such as Trichophyton, Microsporum, and Epidermophyton species. Aspergillus fumigatus, A. flavus, A. niger, and A. tubingensis are the predominant causes of respiratory and systemic infections. Although azoles, echinocandins, and polyenes remain key antifungal agents, rising resistance particularly azole resistance in Aspergillus and echinocandin resistance in Candida poses a major therapeutic challenge.
真菌感染是黎巴嫩日益严重的公共卫生问题,特别是在免疫功能低下的人群中。常见的病原体包括白色念珠菌、光秃假丝酵母菌(光秃假丝酵母菌)、副枯枝假丝酵母菌、热带假丝酵母菌和新出现的克鲁塞假丝酵母菌(Pichia Kudriavzevii),以及毛癣菌、小孢子菌和表皮菌等皮肤真菌。烟曲霉,黄曲霉,黑曲霉和塔宾曲霉是呼吸道和全身感染的主要原因。虽然唑类、棘球白菌素和多烯类仍然是主要的抗真菌药物,但越来越多的耐药性,特别是曲霉对唑类的耐药性和念珠菌对棘球白菌素的耐药性,对治疗构成了重大挑战。
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引用次数: 0
期刊
Journal of Infection and Public Health
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