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。
{"title":"Molecular markers in diagnostics of fungi and fungal mycotoxins: A narrative review","authors":"Maryam Meskini , Mina Rezghi Rami , Rezvan Tavakoli , Masoumeh Salami","doi":"10.1016/j.jiph.2025.103073","DOIUrl":"10.1016/j.jiph.2025.103073","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103073"},"PeriodicalIF":4.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668410","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}
Pub Date : 2025-11-28DOI: 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.
{"title":"Seroprevalence of four zoonotic viral diseases in camels in Qatar","authors":"AlMaha A. AlSaiari , Nada M. Al-Karbi , Maria K. Smatti , Ahmed Gawish , Nahla O. Eltai , Asmaa A. Althani , Hadi M. Yassine","doi":"10.1016/j.jiph.2025.103074","DOIUrl":"10.1016/j.jiph.2025.103074","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Aim</h3><div>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)].</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>p</em> = 0.018).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103074"},"PeriodicalIF":4.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681959","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}
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.
{"title":"Prevalence and genetic characteristics of Staphylococcus capitis proto-NRCS-A clone among colonizing isolates from healthy individuals in Japan","authors":"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","doi":"10.1016/j.jiph.2025.103071","DOIUrl":"10.1016/j.jiph.2025.103071","url":null,"abstract":"<div><h3>Objectives</h3><div><em>S. capitis</em> 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 <em>nsr</em> and <em>tarJ</em>, and carries a type V SCC<em>mec</em>, showing multiple antimicrobial resistance. This study explored the prevalence of the (proto-)NRCS-A clone in healthy individuals and their genetic characteristics in Japan.</div></div><div><h3>Methods</h3><div>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 <em>arcC</em>. The presence of virulence factors and antimicrobial resistance-associated genes were detected by PCR and sequencing. <em>S. capitis</em> isolates were genetically classified by double-locus (<em>arcC</em>-<em>rpoB</em>) sequence typing and peptide profile of PSMβ.</div></div><div><h3>Results</h3><div>Among 221 isolates of CoNS (19 species) recovered from 444 healthy adults, 82 isolates were identified as <em>S. capitis</em>. Virulence factors associated with the NRCS-A clone, i.e., <em>nsr</em>, <em>tarJ</em>, and <em>ebh</em> were detected in 29 %, 11 %, and 51 % of isolates, respectively, while <em>mecA</em>/SCC<em>mec</em> V was positive in only one isolate harboring solely <em>tarJ</em>. <em>arcC</em> and <em>rpoB</em> 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 <em>nsr</em> and <em>tarJ</em> were detected in 5 isolates (6 %), among which two isolates had the same PSMβ profile and <em>arcC</em>-<em>rpoB</em> types as those of the NRCS-A clone prototype strain CR01. The <em>mecA</em>-positive isolate was classified into the same <em>arcC</em>-<em>rpoB</em> lineage as that of CR01.</div></div><div><h3>Conclusion</h3><div>The present study revealed that SCC<em>mec</em>-negative <em>S. capitis</em> with <em>nsr</em>/<em>tarJ</em> (proto-NRCS-A clone) is distributed at low prevalence to healthy individuals in Japan. These isolates belonged to <em>arcC</em>-<em>rpoB</em> lineages close to that of the NRCS-A clone.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103071"},"PeriodicalIF":4.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668415","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}
Pub Date : 2025-11-24DOI: 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 , Yuting Wang , Huihuang Xu , Wenjie Li , 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 < 0.01), while there was no significant difference in all aspects of the COL-R + COL group (P > 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}
Pub Date : 2025-11-22DOI: 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.
{"title":"Comparing definitions of SARS-CoV-2 infection in a prospective household transmission study","authors":"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","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}
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.
{"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 , Hsing-Yi Chung , Ming-Jr Jian , Chih-Kai Chang , Yun-Wen Lai , Cherng-Lih Perng , Feng-Yee Chang , Yuan-Hao Chen , 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}
Pub Date : 2025-11-21DOI: 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.
{"title":"RSV-associated hospitalizations in Bangladeshi children under five: Unveiling the disease burden","authors":"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","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 < 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}
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.
{"title":"Malignant pertussis in infants: 4 new cases in French Guiana","authors":"Cédric Ngila Lubunu , Christelle Samou-Fontcho , Urbain Agbessy Awanou , Narcisse Elenga","doi":"10.1016/j.jiph.2025.103065","DOIUrl":"10.1016/j.jiph.2025.103065","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103065"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616036","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}
Pub Date : 2025-11-21DOI: 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.
{"title":"Association between early dexamethasone administration and mortality in SARS-CoV-2 infection: A cohort study","authors":"Renata Báez-Saldaña , Ernesto Murillo-Trejo , Lina Barranco-Garduño , Juan Carlos Neri-Salvador , Thalia Jacobo-Vargas , Ana Laura Bazany-Rivero , Uriel Rumbo-Nava","doi":"10.1016/j.jiph.2025.103066","DOIUrl":"10.1016/j.jiph.2025.103066","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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^<sup>3</sup>, and albumin below 3 g/dL.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103066"},"PeriodicalIF":4.0,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616030","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}
Pub Date : 2025-11-20DOI: 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.
{"title":"Prevalent fungal pathogens and antifungal resistance in Lebanon: A scoping review","authors":"Yara Khachab , Majd Bou Ghader , Vera Tahesh , Racha Khoumassi , Elie Salem Sokhn","doi":"10.1016/j.jiph.2025.103062","DOIUrl":"10.1016/j.jiph.2025.103062","url":null,"abstract":"<div><div>Fungal infections are an increasing public health concern in Lebanon, particularly among immunocompromised individuals. Common pathogens include <em>Candida albicans</em>, <em>C. glabrata (Nakaseomyces glabrata)</em>, <em>C. parapsilosis</em>, <em>C. tropicalis</em>, and emerging <em>C. krusei (Pichia Kudriavzevii)</em>, alongside dermatophytes such as <em>Trichophyton</em>, <em>Microsporum</em>, and <em>Epidermophyton</em> species. <em>Aspergillus fumigatus</em>, <em>A. flavus</em>, <em>A. niger</em>, and <em>A. tubingensis</em> are the predominant causes of respiratory and systemic infections. Although azoles, echinocandins, and polyenes remain key antifungal agents, rising resistance particularly azole resistance in <em>Aspergillus</em> and echinocandin resistance in <em>Candida</em> poses a major therapeutic challenge.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103062"},"PeriodicalIF":4.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616031","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}