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IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2026-01-01
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引用次数: 0
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2026-01-01
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引用次数: 0
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2026-01-01
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引用次数: 0
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2026-01-01
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引用次数: 0
Integrated computational analysis for Escherichia coli prevalence, genetic evolution, and antimicrobial resistance evolution: Implications for public health and environmental sustainability in Asia 大肠杆菌流行、遗传进化和抗菌素耐药性进化的综合计算分析:对亚洲公共卫生和环境可持续性的影响。
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-12-30 DOI: 10.1016/j.jiph.2025.103117
Ashwini Mallappa , Kuralayanapalya Puttahonnappa Suresh , Sharanagouda S. Patil , Shivasharanappa Nayakvadi , Baldev Raj Gulati , Raghavendra G. Amachawadi , Sudarshan Peramachanahalli Venkatesh , Yamini Sri Sekar , Archana Veeranagouda Patil

Background

Escherichia coli (E. coli), a common gut commensal, includes pathogenic strains responsible for gastrointestinal infections and hemolytic uremic syndrome (HUS). It spreads mainly through contaminated water and food, as well as direct human contact, with the risk being particularly high in densely populated regions. The growing emergence of antimicrobial-resistant (AMR) strains, particularly in Asia, poses serious public health challenges.

Methods

This study employed a multi-tiered computational framework comprising systematic review, quantitative evidence synthesis (meta-analysis), the Markov cluster algorithm with random walks on pan-genomics, and positive selection through evolutionary analysis, shedding light on the prevalence, geographical distribution, genomic diversity, and evolutionary dynamics of E. coli across Asia.

Results

Quantitative evidence synthesis (meta-analysis) technique included 66 articles (total sample n = 1,20,207) and revealed an E. coli prevalence of 18 % (95 % CI:14 %-21 %, I2=100, τ 2=0.0, P = 0) in Asia. The E. coli incidences identified the Indian strain Ec40 collected in 2013 showed the highest genetic diversity, and the sequences collected between 2012 and 2019 displayed the most variation. The emrY gene, recurrently identified within the E. coli genomes, was subjected to evolutionary analysis. Codon-based selection models indicated adaptive evolution, with five codon sites under pervasive selection and twelve under episode selection (ω > 1), suggesting antimicrobial pressure as the main driver of regional adaptation.

Conclusion

These findings underscore the urgent need for integrated prevention and control strategies, including robust surveillance systems to monitor infection trends, targeted interventions to curb transmission, and strengthened biosecurity measures aimed at reducing environmental contamination. Furthermore, the emergence of AMR variants calls for alternative treatment, e.g., bacteriophage therapy, to reduce the clinical and socioeconomic burden of E. coli infections in humans and animal populations.
背景:大肠杆菌是一种常见的肠道共生菌,包括导致胃肠道感染和溶血性尿毒症综合征(HUS)的致病菌株。它主要通过受污染的水和食物以及人类直接接触传播,在人口稠密地区风险特别高。抗微生物药物耐药性(AMR)菌株的日益出现,特别是在亚洲,构成了严重的公共卫生挑战。方法:本研究采用系统综述、定量证据综合(meta分析)、泛基因组随机行走马尔可夫聚类算法、进化分析正向选择等多层计算框架,揭示了大肠杆菌在亚洲的流行、地理分布、基因组多样性和进化动态。结果:定量证据合成(meta分析)技术纳入66篇文章(总样本n = 1,20,207),显示大肠杆菌在亚洲的患病率为18 %(95 % CI:14 %-21 %,I2=100, τ 2=0.0, P = 0)。2013年收集的印度菌株Ec40的大肠杆菌发病率显示出最高的遗传多样性,2012年至2019年收集的序列显示出最大的变异。emrY基因在大肠杆菌基因组中反复发现,并进行了进化分析。基于密码子的选择模型显示了适应性进化,其中5个密码子位点处于普遍选择状态,12个密码子位点处于插曲选择状态(ω > 1),表明抗微生物压力是区域适应的主要驱动因素。结论:这些发现强调迫切需要采取综合预防和控制战略,包括强有力的监测系统以监测感染趋势,有针对性的干预措施以遏制传播,以及加强旨在减少环境污染的生物安全措施。此外,抗菌素耐药性变体的出现要求采用替代治疗,例如噬菌体治疗,以减轻人类和动物群体中大肠杆菌感染的临床和社会经济负担。
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引用次数: 0
Suboptimal primaquine adherence in Plasmodium vivax malaria: Evidence from high-burden tribal districts in Odisha 间日疟原虫疟疾的次优伯氨喹依从性:来自奥里萨邦高负担部落地区的证据
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-12-30 DOI: 10.1016/j.jiph.2025.103123
Anju Viswan K , Kannan Thiruvengadam , Rohit Sharma, Nandhini Perumalsamy, Renuka Devi Arumugam, Srikanth Srirama, Arya Rahul , Manju Rahi

Background

Eliminating Plasmodium vivax malaria in India’s tribal regions is challenging, mainly due to poor adherence to primaquine, the only hypnozoiticidal drug for radical cure under national policy. Incomplete adherence to the 14-day primaquine regimen leads to relapse, treatment failure, ongoing transmission, and may contribute to antimalarial resistance. This study quantified primaquine adherence, and explored behavioral factors influencing non-adherence in high-burden tribal districts of Odisha.

Methods

This prospective cohort study conducted from January to December 2024 in two high-burden tribal districts (Malkangiri, Koraput) enrolled 269 laboratory-confirmed P. vivax patients aged over one year. Structured questionnaires collected demographic, clinical, and treatment data. Adherence to the 14-day primaquine regimen was assessed on days 7 and 14 via self-report, pill counts, and blister pack inspection. Uni- and multivariable analyses identified predictors of non-adherence.

Results

Adherence to chloroquine (3 days) and artesunate–SP (mixed infections) exceeded 93 %, while only 58.7 % (95 % CI: 52.6–64.9) completed the 14-day primaquine course. Healthcare workers dispensed drugs according to guidelines. Treatment discontinuation was mainly due to symptom resolution (61.9 %) and forgetfulness (21.4 %); only one patient discontinued primaquine due to an adverse event. Older age and household malaria history were associated with better adherence.

Conclusion

Suboptimal primaquine adherence delays P. vivax elimination despite adequate drug supply and correct dosing. Addressing behavioral drivers of early treatment cessation is critical to interrupt relapse transmission. Programmatic focus should include intensified social behavior change communication, targeted directly observed therapy, and evaluation of shorter primaquine or single-dose tafenoquine treatments with G6PD testing to enhance radical cure and accelerate India’s 2030 malaria elimination goal.
背景:在印度部落地区划定间日疟原虫疟疾是一项挑战,主要是由于对伯氨喹的依从性差,而伯氨喹是国家政策下唯一用于根治的催眠杀虫药物。不完全坚持14天伯氨喹治疗方案会导致复发、治疗失败、持续传播,并可能导致抗疟药耐药性。本研究量化了奥里萨邦高负担部落地区的伯氨喹依从性,并探讨了影响不依从性的行为因素。方法本前瞻性队列研究于2024年1月至12月在两个高负担部落区(Malkangiri, Koraput)进行,纳入269例1岁以上实验室确诊的间日疟原虫患者。结构化问卷收集了人口统计、临床和治疗数据。在第7天和第14天通过自我报告、药片计数和泡罩包装检查来评估14天伯氨喹方案的依从性。单变量和多变量分析确定了不依从性的预测因素。结果氯喹(3 d)和青蒿琥酯- sp(混合感染)的依从率超过93 %,而完成伯氨喹14 d疗程的只有58.7 %(95 % CI: 52.6 ~ 64.9)。医护人员根据指南配药。停止治疗的主要原因是症状缓解(61.9 %)和健忘(21.4% %);只有一名患者因不良事件停用伯氨喹。年龄较大和家庭疟疾史与较好的依从性相关。结论尽管有充足的药物供应和正确的剂量,但非最佳的伯氨喹依从性会延迟间日疟的消除。解决早期停止治疗的行为驱动因素对于阻断复发传播至关重要。规划重点应包括加强社会行为改变沟通,有针对性的直接观察治疗,以及评估较短的伯氨喹或单剂量他非诺喹治疗与G6PD测试,以加强根治和加速印度2030年消除疟疾的目标。
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引用次数: 0
The genetic diversity of drug resistance in Mycobacterium tuberculosis strains from the Tibetan Plateau 青藏高原结核分枝杆菌耐药遗传多样性研究
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-12-29 DOI: 10.1016/j.jiph.2025.103120
Anyue Xia , Jie Luo , Xiaohui Yu , Sijuan Ding , Dongfang Feng , Bin Zhu , Maoshi Li , Shangshi Li , Li Shi , Huan Xu

Objective

This study aimed to characterize the genetic diversity of drug resistance in Mycobacterium tuberculosis (MTB) isolates from the Tibetan Plateau, elucidate the molecular epidemiological profile of tuberculosis (TB) in this high-altitude region, and offer a molecular basis to guide improved diagnostic, therapeutic, and preventive strategies.

Methods

A total of 169 clinical MTB isolates were collected from the General Hospital of Xizang Military Command between January 2024 and April 2025. Drug resistance-associated mutations were identified via targeted gene sequencing.

Results

Among the 169 isolates, the overall rate of genotypic resistance was 20.71 %, comprising mono-resistance (14.79 %), poly-resistance (1.78 %), and multidrug-resistance (MDR, 4.14 %). Retreated patients exhibited a higher resistance rate than newly treated cases (26.09 % vs. 14.29 %), with MDR exclusively identified in the retreatment group. Resistance to streptomycin was most prevalent (8.28 %), followed by isoniazid (7.69 %) and rifampicin (7.10 %). The predominant mutations observed were rpsL K43R and katG S315T. No mutations conferring resistance to second-line drugs were detected.

Conclusion

The substantial burden of drug-resistant TB on the Tibetan Plateau—particularly streptomycin resistance—underscores the critical need for implementing precision diagnostics and optimizing therapeutic regimens.
目的研究青藏高原结核分枝杆菌(MTB)耐药遗传多样性,阐明该地区结核病的分子流行病学特征,为改进诊断、治疗和预防策略提供分子基础。方法收集西藏军区总医院2024年1月~ 2025年4月临床结核分枝杆菌分离株169株。通过靶向基因测序鉴定耐药相关突变。结果169株菌株基因型总耐药率为20.71 %,其中单耐药(14.79 %)、多耐药(1.78 %)、多药耐药(4.14 %)。复发患者的耐药率高于新治疗患者(26.09 % vs. 14.29 %),耐多药仅在再治疗组中发现。链霉素耐药最多(8.28 %),其次是异烟肼(7.69 %)和利福平(7.10 %)。观察到的主要突变是rpsL K43R和katG S315T。未发现对二线药物产生耐药性的突变。结论青藏高原耐药结核病的巨大负担,特别是链霉素耐药性,强调了实施精确诊断和优化治疗方案的迫切需要。
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引用次数: 0
Best Paper Award “Journal of Infection and Public Health” – 2025 Edition 最佳论文奖“感染与公共卫生杂志” - 2025年版
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-12-29 DOI: 10.1016/j.jiph.2025.103125
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引用次数: 0
Epidemiological and clinical trends in pediatric dengue: A six-year retrospective hospital-based study on pre-vs pandemic patterns in Puducherry, India 儿科登革热的流行病学和临床趋势:印度普杜切里一项基于医院的6年回顾性研究
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-12-29 DOI: 10.1016/j.jiph.2025.103121
Arya Rahul , Gnanasekaran Vijayalaksmi , Balakrishnan Vijayakumar , R. Amala , B.V. Balachandar , Thekkumkara Surendran Anish

Background

Dengue is a rapidly spreading mosquito-borne viral disease posing a significant public health challenge across tropical and subtropical regions, including India. While children are particularly vulnerable, age-specific clinical and epidemiological trends remain underexplored, especially in low-and middle-income country settings. This study describes the clinical and epidemiological trends of pediatric dengue in Puducherry from 2017 to 2022 and the impact of the COVID-19 pandemic on the disease trends.

Methods

A retrospective review was conducted on 632 pediatric patients admitted with dengue fever to a woman and child speciality public sector tertiary care hospital in Puducherry between 2017 and 2022. Data on demographic, clinical, and laboratory parameters were extracted from inpatient records. Dengue severity was categorized using WHO 2009 criteria. Statistical analyses were performed to assess associations and identify risk factors.

Results

Among the 632 patients, 54 % showed warning signs of dengue, and 3.5 % progressed to severe dengue. Fever (99.0 %), vomiting(51.3 %), and abdominal pain(37.3 %) were the common symptoms. Children under five years were significantly more likely to present with respiratory symptoms (cough: OR 1.85(1.27–2.70), p = 0.001; rhinitis: OR 1.67(1.13–2.46), p = 0.01), while gastrointestinal and musculoskeletal complaints were more common in the older children. The mean duration from symptom onset to diagnosis was 5.8 ± 2.8 days, with a significant prolongation in children aged 1–5 years (6.5 ± 3.6 days, p = 0.013). During the COVID-19 pandemic (2020–2022), time to diagnosis increased significantly (≥7 days in 27.2 % vs. 15.5 % pre-pandemic, OR 2.03, p < 0.001), although no significant differences in disease severity or demographic characteristics were noted.

Conclusions

This study highlights distinct age-related clinical patterns in pediatric dengue, with younger children tending to present more likely with respiratory symptoms and experience a longer time to diagnosis. Strengthening clinical recognition, adapting age-appropriate diagnostic protocols, and promoting early care-seeking are essential for timely detection and response to dengue in endemic regions.
登革热是一种迅速传播的蚊媒病毒性疾病,对包括印度在内的热带和亚热带地区的公共卫生构成重大挑战。虽然儿童特别脆弱,但针对特定年龄的临床和流行病学趋势仍未得到充分探讨,特别是在低收入和中等收入国家环境中。本研究描述了2017 - 2022年普杜切里县儿童登革热的临床和流行病学趋势,以及2019冠状病毒病大流行对疾病趋势的影响。方法对2017 - 2022年印度普杜切里市某妇幼专科公立三级医院收治的632例登革热患儿进行回顾性分析。人口统计、临床和实验室参数的数据从住院患者记录中提取。根据世卫组织2009年的标准对登革热严重程度进行了分类。进行统计分析以评估关联并确定危险因素。结果632例患者中,54. %出现登革热前兆,3.5% %进展为重症登革热。常见症状为发热(99.0 %)、呕吐(51.3 %)、腹痛(37.3 %)。5岁以下儿童明显更容易出现呼吸道症状(咳嗽:OR 1.85(1.27-2.70), p = 0.001;鼻炎:OR 1.67(1.13-2.46), p = 0.01),而胃肠和肌肉骨骼疾患在年龄较大的儿童中更为常见。从症状出现到诊断的平均时间为5.8 ± 2.8天,1-5岁儿童的平均时间明显延长(6.5 ± 3.6天,p = 0.013)。在COVID-19大流行期间(2020-2022),诊断时间显着增加(27.2% % vs. 15.5% %,OR 2.03, p <; 0.001),尽管没有注意到疾病严重程度或人口统计学特征的显着差异。结论:本研究突出了儿童登革热不同的年龄相关临床模式,年龄较小的儿童更容易出现呼吸道症状,并且需要更长的时间才能确诊。加强临床认识、调整适合年龄的诊断方案和促进早期求医,对于在登革热流行地区及时发现和应对登革热至关重要。
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引用次数: 0
Calls for papers: Antimicrobial resistance and one health: interdisciplinary strategies to address a global challenge – Virtual special issue 征文:抗菌素耐药性和一种健康:应对全球挑战的跨学科战略——虚拟特刊
IF 4 3区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2025-12-27 DOI: 10.1016/j.jiph.2025.103122
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引用次数: 0
期刊
Journal of Infection and Public Health
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