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Understanding the interests of academics from diverse disciplines to identify the prospective focus for a UK-based transdisciplinary network involving farm-to-fork stakeholders on antimicrobial resistance in agrifood systems: An online survey 了解来自不同学科的学者的兴趣,以确定英国跨学科网络的未来重点,该网络涉及农业食品系统中从农场到餐桌的抗菌药耐药性问题:在线调查
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.1016/j.onehlt.2024.100884

Antimicrobial resistance (AMR) evolution and onward transmission of resistance genes is impacted by interrelated biological and social drivers, with evidence and impacts observed across human, animal and environmental One Health domains. Systems-based research examining how food production impacts on AMR in complex agrifood systems is lacking, with little written on management approaches in the UK that might prevent and respond to this challenge. One approach is the creation of a transdisciplinary network to enhance capacity, capability and collaboration between agrifood-focused disciplines and stakeholders. This co-creation platform for network-wide systems-based activities would reduce inefficiencies in AMR-related activities around agrifood, providing a cross-cutting, cohesive community to deliver transformational guidance on relevant, practical agrifood solutions that add value by reducing AMR, antimicrobial usage and associated costs, and decreasing resultant environmental contamination by prioritising challenges, sharing knowledge and best practice, and co-creating practical solutions with key stakeholders. An online survey determined prospective network focus, structure and priorities, with responses analysed using mixed methods.

Survey results suggested respondents have interests in synthesising data using systems-approaches and using certain disciplines such as ‘social sciences’ within network activities. There were disconnects in how and whom to work with on this, with generalised use of ‘social science/scientists’ but lack of disciplinary understanding (e.g., anthropology, sociology) suggesting disciplinary differences awareness-training is useful. A similar generalisation is seen for mathematics/statistics. There are strong interests in working with food system practitioners (e.g., farmers/vets), providing opportunities for farm/field visits/knowledge exchange, and human health, reflecting the need for farm-to-fork understanding of impacts. There were notable mentions of policy/governance, emphasising translational research desires to create meaningful change. Disciplines/fields did not always align with identified interests e.g., systems and implementation science, suggesting the utility of network activity around introducing these disciplines e.g., methodology-focused rather than subject-focused conferences exploring lateral thinking about subjects. We suggest starting by developing understanding of the most important research questions by working with stakeholders, then working back to how we would achieve desirable project outcomes and who else is needed for this.

抗菌素耐药性(AMR)的演变和耐药性基因的继续传播受到相互关联的生物和社会驱动因素的影响,在人类、动物和环境的 "一个健康 "领域都可以观察到证据和影响。目前还缺乏以系统为基础的研究,来探讨在复杂的农粮系统中,食品生产如何对 AMR 产生影响。一种方法是创建一个跨学科网络,以加强以农业食品为重点的学科和利益相关者之间的能力和协作。这一网络范围内基于系统活动的共同创造平台将减少围绕农业食品开展的 AMR 相关活动中的低效现象,提供一个跨领域、有凝聚力的社区,就相关、实用的农业食品解决方案提供变革性指导,通过优先应对挑战、共享知识和最佳实践以及与主要利益相关者共同创造实用解决方案,减少 AMR、抗菌素的使用和相关成本,降低由此造成的环境污染,从而实现增值。一项在线调查确定了未来网络的重点、结构和优先事项,并采用混合方法对答复进行了分析。调查结果表明,受访者对利用系统方法综合数据以及在网络活动中利用某些学科(如 "社会科学")感兴趣。在如何合作以及与谁合作方面存在脱节,普遍使用 "社会科学/科学家",但缺乏学科理解(如人类学、社会学),这表明学科差异意识培训是有用的。数学/统计学也有类似的普遍性。人们对与粮食系统从业人员(如农民/兽医)合作、提供农场/实地考察/知识交流的机会以及人类健康有着浓厚的兴趣,这反映出需要了解从农场到餐桌的影响。还有人明显提到了政策/管理,强调转化研究希望创造有意义的变革。学科/领域并不总是与已确定的兴趣相一致,例如系统和实施科学,这表明围绕介绍这些学科的网络活动是有用的,例如探讨学科横向思维的以方法论为重点而不是以学科为重点的会议。我们建议,首先通过与利益相关者合作,了解最重要的研究问题,然后再回过头来研究如何实现理想的项目成果,以及为此还需要哪些人。
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引用次数: 0
Reaching consensus amongst international experts on the use of high importance-rated antimicrobials in animals – a Delphi study 国际专家就在动物中使用高重要度抗菌剂达成共识--德尔菲研究
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-26 DOI: 10.1016/j.onehlt.2024.100883

In Australia, antimicrobials are given an importance rating by the Australian Strategic and Technical Advisory Group on antimicrobial resistance. High importance antimicrobials are those essential for the treatment or prevention of infections in humans, where there are few or no treatment alternatives. In this study we consulted with experts from across human and animal health using the Delphi consensus-building process to establish the circumstances under which antimicrobials with high importance to human health could be used in animals in Australia. We used three rounds of online surveys. Group responses were provided to participants in each subsequent round to facilitate convergence of opinion. Consensus was defined as 80 % or more of respondents selecting the same option for a question. By the end of the third round, consensus was achieved on eight items. This included the use of high importance antimicrobials being appropriate if culture and sensitivity testing indicated the organism was resistant to low- and medium-rated antimicrobials that could be used to treat the case. If any high-importance antimicrobials are prescribed for animals there was also agreement that a clear indication for this use and justification for antimicrobial choice must be recorded in the medical history, along with the dose rate, route of administration, the duration and the time point for review of the condition and associated antimicrobial therapy.

Appropriateness of use of high importance antimicrobials in critically ill animals where culture and sensitivity results are not available is still undefined. Further work is also required to establish which particular organisation should be notified of the use of high importance antimicrobials not registered for use in animals. The Delphi process was valuable in facilitating consensus amongst international experts from a broad range of health backgrounds and experience.

在澳大利亚,澳大利亚抗菌药耐药性战略和技术咨询组对抗菌药进行了重要性评级。重要性高的抗菌药是指那些对治疗或预防人类感染至关重要的抗菌药,在这种情况下,几乎没有或根本没有替代治疗方法。在这项研究中,我们采用德尔菲法(Delphi)建立共识的程序,咨询了人类健康和动物健康领域的专家,以确定在哪些情况下,对人类健康具有高度重要性的抗菌药物可用于澳大利亚的动物。我们使用了三轮在线调查。在随后的每一轮调查中,我们都会向参与者提供小组答复,以促进意见的统一。80%或以上的受访者对某个问题选择了相同的选项,即为达成共识。到第三轮结束时,已就八个项目达成共识。其中包括:如果培养和药敏试验表明,病菌对可用于治疗该病例的中低级抗菌药物具有耐药性,则应适当使用高重要性抗菌药物。如果为动物开具任何高重要性抗菌药物处方,与会者还一致认为,必须在病历中记录明确的使用指征和选择抗菌药物的理由,以及剂量、给药途径、持续时间和复查病情及相关抗菌药物治疗的时间点。还需要进一步开展工作,以确定在使用未注册用于动物的高活性抗菌药物时应通知哪个特定组织。德尔菲过程对于促进具有广泛卫生背景和经验的国际专家达成共识非常有价值。
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引用次数: 0
High prevalence of hepatitis E and rat hepatitis E viruses in wastewater in Gothenburg, Sweden 瑞典哥德堡废水中戊型肝炎病毒和大鼠戊型肝炎病毒的高流行率
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-22 DOI: 10.1016/j.onehlt.2024.100882

Hepatitis E virus (HEV) and Rat Hepatitis E virus (RHEV), recognized for their zoonotic potential, pose significant public health concerns. Our previous research identified both viruses in effluent wastewater in Gothenburg, Sweden. However, there are lingering inquiries regarding the prevalence and genetic diversity of these viruses in influent wastewater, as well as the utility of wastewater surveillance in elucidating their community circulation dynamics. To address these knowledge gaps, we conducted weekly collection of wastewater samples at the Rya wastewater treatment plant in Gothenburg throughout 2023. The concentrations of HEV and RHEV were quantified using quantitative polymerase chain reaction (qPCR). Additionally, two semi/nested-PCR were utilized to amplify viral strains. Furthermore, HEV strains from patients within the same region, as well as other regions in Sweden in 2023, were incorporated into the analysis. Remarkably, we observed a high prevalence of HEV (86%) and RHEV (98%) in wastewater samples, with the majority of HEV sequences identified as subtype 3c/i (9/12). In contrast, HEV subtype 3f was the most sequenced among clinical patient samples (6/12). Notably, previously unreported HEV-3b and unclassified strains were detected in wastewater. Almost all RHEV strains (20/21) were clustered into European groups, with none of the RHEV genetically close to strains previously found in human cases. The notable discordance in prevalence and identified subtypes of HEV-3 in wastewater compared to clinical samples suggests either a significant underdiagnosis of HEV infections or differences in viral loads and shedding durations among humans between HEV-3 subtypes. This underscores the urgent need for improved diagnostic techniques and heightened awareness of HEV transmission dynamics. Furthermore, the consistent detection of RHEV in wastewater underscores the necessity for further investigations to assess the potential role of RHEV in hepatitis cases of unknown etiology, given that most currently available clinical diagnostic assays fail to detect RHEV.

戊型肝炎病毒(HEV)和大鼠戊型肝炎病毒(RHEV)被认为具有人畜共患病的潜能,对公众健康构成了严重威胁。我们之前的研究在瑞典哥德堡的污水废水中发现了这两种病毒。然而,关于这些病毒在流入废水中的流行程度和遗传多样性,以及废水监测在阐明其群落循环动态方面的效用,仍有很多问题有待探究。为了填补这些知识空白,我们在 2023 年期间每周都在哥德堡的 Rya 污水处理厂采集废水样本。我们使用定量聚合酶链反应 (qPCR) 对 HEV 和 RHEV 的浓度进行了量化。此外,还利用两种半/巢式 PCR 技术扩增病毒株。此外,同一地区以及 2023 年瑞典其他地区患者的 HEV 株系也被纳入分析范围。值得注意的是,我们观察到废水样本中 HEV(86%)和 RHEV(98%)的流行率很高,其中大多数 HEV 序列被鉴定为 3c/i 亚型(9/12)。相比之下,在临床患者样本中,HEV 3f 亚型的测序结果最多(6/12)。值得注意的是,在废水中检测到了以前未报道过的 HEV-3b 和未分类的菌株。几乎所有的 RHEV 菌株(20/21)都聚集在欧洲组中,没有一个 RHEV 在基因上与以前在人类病例中发现的菌株接近。与临床样本相比,HEV-3 在废水中的流行率和确定的亚型明显不一致,这表明 HEV 感染的诊断率明显偏低,或者 HEV-3 亚型之间的病毒载量和人类脱落时间存在差异。这突出表明,迫切需要改进诊断技术并提高对 HEV 传播动态的认识。此外,在废水中持续检测到 RHEV 突出表明有必要进行进一步调查,以评估 RHEV 在病因不明的肝炎病例中的潜在作用,因为目前可用的大多数临床诊断方法都无法检测到 RHEV。
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引用次数: 0
Characterization of methicillin resistant Staphylococcus Aureus in municipal wastewater in Finland 芬兰城市污水中耐甲氧西林金黄色葡萄球菌的特征
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-21 DOI: 10.1016/j.onehlt.2024.100881

Wastewater-based surveillance (WBS) of multidrug-resistant bacteria could complement clinical data, serving as a population-level early warning tool. This study evaluated WBS as a pandemic preparedness tool, by selectively isolating and culturing methicillin-resistant Staphylococcus aureus (MRSA) with CHROMagar MRSA. Some 24-h composite wastewater samples (n = 80) were collected from ten treatment plants across Finland between February 2021 and January 2022. MRSA prevalence in wastewater samples was 27.5% (n = 22/80), showing seasonal and temporal variations. Phenotypic antimicrobial susceptibility testing (AST) with microdilution showed that over 80% of isolates were drug-resistant to clindamycin, sulfamethoxazole/trimethoprim, tetracycline, fusidic acid, and erythromycin. Four isolates (18.2%) were vancomycin-resistant. WGS revealed that 31.8% (n = 7) of the isolates belonged to the ST8-t008 and ST6-t304 spa types, respectively. In addition, two spa types (t011 and t034) belong to the CC398 complex. The mecA gene was found in all isolates (n = 22) and three tetracycline resistance determinants (tet38, tetK, and tetM) were detected with tet38 being the most abundant (81.8%, n = 18/22). Three isolates harboured the plasmid-mediated sat4 gene that confers resistance to Streptothricin. In addition, resistance determinants to macrolide antibiotics (mph (C)/msr (A) and fosfomycin (fosB) were detected in the seven isolates that belonged to spa type t008. All isolates except one harboured the SCCmec_type_IVa(2B). Six ST8 isolates harboured the LukS/F-PV genes encoding the Panton–Valentine leukocidin (PVL) and were also positive for the Arginine Catabolic Mobile Element (ACME), suggesting they belong to the USA300 clone. The Inc18 plasmid was the most abundant as it was detected in 72.7% (n = 16/22) of the isolates. Other plasmid replicons detected were the rep_trans and repA_N which were detected in 45.4% (n = 10/22) and 40.9% (n = 9/22) of the isolates respectively. Ten isolates harboured at least three plasmid replicons and no plasmid replicons were detected in four isolates (ST6/t304). The cgMLST revealed that some isolates aggregated into two genomically indistinguishable clusters: ST6/t304 belonging to cluster type CT12405 (≤20 allelic differences) and ST8/t008 belonging to cluster type CT1925 (<8 allelic differences). Overall, we found a high genotypic concordance with the national clinical bacterial resistance data. Our study demonstrates the sensitivity of culture-based wastewater surveillance for MRSA using clinical media following pre-enrichment, reliably predicting pathogen occurrence at the population level.

对耐多药细菌的废水监测(WBS)可以补充临床数据,成为一种人群预警工具。本研究通过使用 CHROMagar MRSA 选择性地分离和培养耐甲氧西林金黄色葡萄球菌(MRSA),对将 WBS 作为大流行病防备工具进行了评估。2021 年 2 月至 2022 年 1 月期间,从芬兰各地的 10 家污水处理厂收集了一些 24 小时复合废水样本(n = 80)。废水样本中的 MRSA 感染率为 27.5%(n = 22/80),并呈现季节性和时间性变化。采用微量稀释法进行的表型抗菌药敏感性测试(AST)显示,80%以上的分离菌株对克林霉素、磺胺甲恶唑/三甲氧苄啶、四环素、夫西地酸和红霉素耐药。四个分离株(18.2%)对万古霉素耐药。WGS 显示,31.8%(n = 7)的分离株分别属于 ST8-t008 和 ST6-t304 spa 类型。此外,两个 spa 类型(t011 和 t034)属于 CC398 复合物。在所有分离株(n = 22)中都发现了 mecA 基因,并检测到三种四环素抗性决定簇(tet38、tetK 和 tetM),其中 tet38 的含量最高(81.8%,n = 18/22)。三个分离株携带质粒介导的 sat4 基因,该基因可产生对链霉素的抗性。此外,在属于 spa 类型 t008 的 7 个分离物中检测到了对大环内酯类抗生素(mph (C)/msr (A) 和磷霉素 (fosB) 的抗性基因。除一个分离株外,所有分离株都携带 SCCmec_type_IVa(2B)。6 个 ST8 分离物携带有编码 Panton-Valentine leukocidin(PVL)的 LukS/F-PV 基因,精氨酸代谢移动元件(ACME)也呈阳性,表明它们属于 USA300 克隆。在72.7%(n = 16/22)的分离株中检测到了Inc18质粒,因此它的数量最多。检测到的其他质粒复制子是 rep_trans 和 repA_N,分别在 45.4%(n = 10/22)和 40.9%(n = 9/22)的分离物中检测到。10 个分离株至少携带 3 个质粒复制子,4 个分离株(ST6/t304)未检测到质粒复制子。cgMLST 显示,一些分离物聚集成两个基因组上无法区分的群:ST6/t304 属于聚类类型 CT12405(等位基因差异≤20),ST8/t008 属于聚类类型 CT1925(等位基因差异<8)。总体而言,我们发现基因型与全国临床细菌耐药性数据高度一致。我们的研究表明,在预富集后使用临床培养基对 MRSA 进行基于培养的废水监测非常灵敏,可以可靠地预测病原体在人群中的发生率。
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引用次数: 0
Ecosystem health appears neglected in the management of the human-macaque interface: A systematic review 生态系统健康似乎在人类-马卡克界面管理中被忽视了:系统回顾
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-20 DOI: 10.1016/j.onehlt.2024.100875

Macaques (Macaca spp.) are reported in human-wildlife interaction in anthropogenic areas. The management of human-macaque interactions (HMI) requires an understanding of various perspectives and knowledge. One Health (OH) is a transdisciplinary approach to address the well-being and health of animals, humans, and ecosystems, which supports sustainable management through its three pillars: economy, ecology, and society. Thus, the OH approach could be applied to HMI management. To explore the HMI management within the context of the OH approach, we examined articles related to the management of HMI from 2013 to 2022 following the systematic review by PRISMA guidelines. Ninety-four publications were included in the study. Then, we extracted information on HMI framing, management activities, species, and location and categorized HMI framings and management activities into themes of three OH domains and three pillars of sustainability. We noticed an underrepresentation of the society and economy pillars in HMI management and the ecosystem health domain was the least explored in both the HMI and management activities. When we connected publications addressing all three pillars with OH domains in management activities, the number focused on ecosystem health (3/13) remained limited. The most frequently reported HMI theme was “crop feeding”(n=42) and management activities were “HMI management” (n=42). Most publications lacked any form of evaluation of the HMI management. The challenges to better consider ecosystem health in the HMI and to promote participatory governance present an opportunity to apply the OH approach in wildlife conservation and management.

据报道,猕猴(Macaca spp.)管理人与猕猴的互动(HMI)需要了解各种观点和知识。一体健康(OH)是一种跨学科方法,用于解决动物、人类和生态系统的福祉和健康问题,通过其三大支柱(经济、生态和社会)支持可持续管理。因此,"健康 "方法可应用于人机界面管理。为了在 "OH "方法的背景下探讨HMI管理,我们按照PRISMA指南对2013年至2022年与HMI管理相关的文章进行了系统性审查。研究共纳入了 94 篇出版物。然后,我们提取了有关人机界面框架、管理活动、物种和地点的信息,并将人机界面框架和管理活动分为三个 OH 领域和三个可持续发展支柱的主题。我们注意到,社会和经济支柱在 HMI 管理中的代表性不足,而生态系统健康领域在 HMI 和管理活动中的探索最少。当我们将涉及所有三大支柱的出版物与管理活动中的 OH 领域联系起来时,关注生态系统健康的出版物(3/13)数量仍然有限。报告最多的人机界面主题是 "作物饲养"(42 篇),管理活动是 "人机界面管理"(42 篇)。大多数出版物缺乏对 HMI 管理的任何形式的评估。在 HMI 中更好地考虑生态系统健康和促进参与式治理所面临的挑战为在野生动物保护和管理中应用 OH 方法提供了机会。
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引用次数: 0
Capillaria hepatica (syn. Calodium hepaticum) infection and factors influencing infection carriage in rats (Rattus spp.) in Hong Kong 香港老鼠(Rattus spp.
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-20 DOI: 10.1016/j.onehlt.2024.100878

Capillaria hepatica (syn. Calodium hepaticum) (Bancroft, 1893) is a nematode, which colonises the liver of a wide range of hosts including humans. The worldwide prevalence of infection in the genus Rattus can be as high as 100% and the Norway rat (R. norvegicus) and black rat (R. rattus) are considered the main host species. This study is the first to investigate the epidemiology of C. hepatica infection in wild rats trapped in various geographical locations in Hong Kong. Four species of trapped rats were identified, with 65% being R. norvegicus, followed by 30% R. tanezumi (Asian house rat), 4% R. andamanensis (Sikkim rat), and 1% Niviventer huang (South China white-bellied rat). The overall prevalence of C. hepatica infection was 36.7% (81/221) (95% CI 30.4–43.4) and R. norvegicus was the most common rat species trapped during this study, with the highest prevalence of C. hepatica infection. Two risk factors for host infection were skin wounds and geographical region, whilst sex, body weight, stage of development, and presence of ectoparasites were not risk factors for this infection. Gross hepatic lesions were absent in 17% of infected rats and when present, were not pathognomonic for the infection. Infected rats lacked severe hepatic inflammation or fibrosis, indicating that rats tolerate the infection well. Egg production was observed in the livers of 69% of infected rats, which emphasizes their role as reservoirs of this zoonotic parasite. Several infected rats in this study were trapped inside residential buildings, which highlights the zoonotic risk of C. hepatica to humans following the potential ingestion of embryonated eggs from contaminated food, water, or soil.

肝毛囊线虫(Capillaria hepatica)(同义:Calodium hepaticum)(Bancroft,1893 年)是一种线虫,可在包括人类在内的多种宿主的肝脏中定植。鼠属线虫的全球感染率可高达 100%,挪威鼠(R. norvegicus)和黑鼠(R. rattus)被认为是主要宿主物种。本研究首次调查在香港不同地点捕获的野鼠感染肝包虫病的流行病学。被诱捕的野鼠有四个品种,其中65%是R. norvegicus,其次是30% R. tanezumi(亚洲家鼠)、4% R. andamanensis(锡金鼠)和1% Niviventer huang(华南白腹鼠)。肝吸虫感染的总体流行率为 36.7% (81/221)(95% CI 30.4-43.4),诺维格鼠是本研究中最常见的被捕获鼠种,其肝吸虫感染率最高。宿主感染的两个风险因素是皮肤伤口和地理区域,而性别、体重、发育阶段和体外寄生虫的存在不是感染的风险因素。17%的受感染大鼠没有肝脏大面积病变,即使有,也不是感染的标志性病变。受感染的大鼠没有严重的肝脏炎症或纤维化,这表明大鼠对感染的耐受性良好。在 69% 的受感染大鼠肝脏中观察到了产卵现象,这表明它们是这种人畜共患病寄生虫的储库。在这项研究中,几只受感染的大鼠被困在居民楼内,这突显了肝包虫病对人类的人畜共患风险,因为人类可能会从受污染的食物、水或土壤中摄入胚胎虫卵。
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引用次数: 0
Klebsiella pneumoniae species complex: From wastewater to the environment 肺炎克雷伯氏菌复合菌种:从废水到环境
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-17 DOI: 10.1016/j.onehlt.2024.100880

Klebsiella pneumoniae plays a significant role in nosocomial infections and spreading antibiotic resistance, and therefore forms a major threat to public health. In this study, we investigated the role of the wastewater pathway in the spread of pathogenic bacteria and more specifically, in the spread of antibiotic resistant Klebsiella pneumoniae subspecies. Whole-genome sequencing was performed of 185 K. pneumoniae isolates collected from hospital, nursing home, and community wastewater, the receiving wastewater treatment plant (WWTP), and clinical isolates from the investigated hospital. K. pneumoniae isolates from different sources were not genetically related, except for WWTP influent (46.5%) and effluent (62.5%), revealing survival of bacteria from wastewater treatment. The content of antibiotic resistance (ARGs), virulence, and plasmid replicon genes differed between K. pneumoniae subspecies and their origin. While chromosomal bla genes were specific for each K. pneumoniae subspecies, bla genes predicted in plasmid contigs were found in several K. pneumoniae subspecies, implying possible gene transfer between subspecies. Transferable ARGs were most abundant in patients and hospital isolates (70%), but the average number of plasmid replicon genes per isolate was similar across all sources, showing plasmid content being more relevant than plasmid quantity. Most patient (90%) and hospital wastewater (34%) isolates were K. pneumoniae subsp. pneumoniae, and the yersiniabactin cluster genes ybt, fyuA, and irp12 were only found in this subspecies, as were the IncFII(pECLA), IncHI2A, and IncHI2 plasmid replicon genes, suggesting the clinical origin of these type of plasmids.

肺炎克雷伯菌在医院内感染和抗生素耐药性传播中扮演着重要角色,因此对公共卫生构成了重大威胁。在这项研究中,我们调查了废水途径在致病菌传播中的作用,更具体地说,是在耐抗生素肺炎克雷伯菌亚种传播中的作用。我们对从医院、疗养院和社区废水、接收废水的污水处理厂(WWTP)中收集的 185 株肺炎克雷伯菌分离物以及调查医院的临床分离物进行了全基因组测序。除污水处理厂进水(46.5%)和出水(62.5%)外,不同来源的肺炎克雷伯菌分离物在基因上没有关联,这表明细菌在污水处理过程中得以存活。肺炎克雷伯菌亚种及其来源的抗生素耐药性(ARGs)、毒力和质粒复制子基因的含量各不相同。虽然染色体上的 bla 基因是每个肺炎克氏菌亚种所特有的,但质粒等位基因组中预测的 bla 基因在多个肺炎克氏菌亚种中都有发现,这意味着亚种之间可能存在基因转移。可转移的 ARGs 在患者和医院分离物中最多(70%),但所有来源的分离物中每个分离物的质粒复制子基因平均数量相似,这表明质粒含量比质粒数量更重要。大多数患者(90%)和医院废水(34%)分离物都是肺炎克氏菌肺炎亚种,只有在该亚种中才发现了yersiniabactin簇基因ybt、fyuA和irp12,以及IncFII(pECLA)、IncHI2A和IncHI2质粒复制子基因,这表明这类质粒来源于临床。
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引用次数: 0
Revisiting the risk of introduction of Japanese encephalitis virus (JEV) into the United States – An updated semi-quantitative risk assessment 重新审视日本脑炎病毒(JEV)传入美国的风险--最新的半定量风险评估
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-17 DOI: 10.1016/j.onehlt.2024.100879

Japanese encephalitis virus (JEV) is associated with encephalitis in humans and reproductive and neurological illness in pigs. JEV has expanded beyond its native distribution in southeast Asia, with identifications in Europe (2010) and Africa (2016), and most recently, its spread into mainland Australia (2021−2022). The introduction of JEV into the United States (US) is a public health risk, and could also impact animal health and the food supply. To efficiently and cost-effectively manage risk, a better understanding of how and where diseases will be introduced, transmitted, and spread is required. To achieve this objective, we updated our group's previous qualitative risk assessment using an established semi-quantitative risk assessment tool (MINTRISK) to compare the overall rate of introduction and risk, including impacts, of JEV in seven US regions. The rate of introduction from the current region of distribution was considered negligible for the Northeast, Midwest, Rocky Mountain, West, Alaska, and Hawaii regions. The South region was the only region with a pathway that had a non-negligible rate of introduction; infected mosquito eggs and larvae introduced via imported used tires (very low; 95% uncertainty interval (UI) = negligible to high). The overall risk estimate for the South was very high (95% UI = very low to very high). Based on this risk assessment, the South region should be prioritized for surveillance activities to ensure the early detection of JEV. The assumptions used in this risk assessment, due to the lack of information about the global movement of mosquitoes, number of feral pigs in the US, the role of non-ardeid wild birds in transmission, and the magnitude of the basic reproduction ratio of JEV in a novel region, need to be fully considered as these impact the estimated probability of establishment.

日本脑炎病毒(JEV)与人类脑炎以及猪的生殖和神经系统疾病有关。JEV 的分布范围已超出其在东南亚的原产地,在欧洲(2010 年)和非洲(2016 年)也发现了它的踪迹,最近还蔓延到了澳大利亚大陆(2021-2022 年)。JEV传入美国是一种公共卫生风险,也可能影响动物健康和食品供应。为了高效、经济地管理风险,我们需要更好地了解疾病将如何以及在何处传入、传播和扩散。为了实现这一目标,我们使用成熟的半定量风险评估工具(MINTRISK)更新了我们小组之前的定性风险评估,比较了 JEV 在美国七个地区的总体传入率和风险(包括影响)。东北地区、中西部地区、落基山地区、西部地区、阿拉斯加地区和夏威夷地区认为目前分布地区的引入率可以忽略不计。南部地区是唯一一个传入率不可忽略的地区;受感染的蚊子卵和幼虫通过进口旧轮胎传入(非常低;95% 不确定区间 (UI) = 可忽略到高)。南方的总体风险估计值非常高(95% UI = 非常低到非常高)。根据这一风险评估,南部地区应优先开展监测活动,以确保及早发现 JEV。由于缺乏有关蚊子全球移动、美国野猪数量、非长尾野鸟在传播中的作用以及 JEV 在新地区的基本繁殖率大小的信息,因此需要充分考虑该风险评估中使用的假设,因为这些假设会影响估计的建立概率。
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引用次数: 0
Prevalence of Flavivirus and Alphavirus in bats captured in the state of Yucatan, southeastern Mexico 墨西哥东南部尤卡坦州捕获的蝙蝠中流行的黄热病病毒和阿尔法病毒
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-15 DOI: 10.1016/j.onehlt.2024.100876

Flavivirus (family Flaviviridae) and Alphavirus (family Togaviridae) are mosquito-borne viruses that poses a significant risk to public health worldwide. Examples of these viruses include Dengue virus (DENV) and Zika virus (ZIKV) in the Flavivirus genus, and Chikungunya virus (CHIKV) in the Alphavirus genus. The potential contribution of bats in the mosquito-to-human transmission cycle of these viral genera in the tropics has not been studied. Here, a total of 144 bats belonging to three families (Emballonuridae, Phyllostomidae, and Molossidae) and six species were captured for one year using mist nets in sites with different landscapes (forest and grassland) in the state of Yucatan, southeastern Mexico. Blood samples and rectal and oral swabs were collected to detect Flavivirus and Alphavirus RNA genomes through RT-PCR. Flavivirus RNA was detected in 53 individuals (36.8%; 95% CI: 29.4%–44.9%), and Alphavirus RNA was detected in 59 individuals (40.1%; 95% CI: 33.2%–49.2%). The sequences obtained were consistent with ZIKV and DENV, into the Flavivirus, and CHIKV into the Alphavirus positive samples. The prevalence of both Flavivirus and Alphavirus was higher during the dry season compared with the rainy season. This high positivity rate, highlighted in both Flavivirus and Alphavirus, suggests a potential contribution of bats in the circulation of these viral genera in sylvatic environments. Seasonal variation in viral genera prevalence, with higher prevalence during dry seasons than rainy seasons, may suggest specific viral activity patterns in response to climatic conditions.

黄热病毒(黄热病毒科)和阿尔法病毒(阿尔法病毒科)是由蚊子传播的病毒,对全球公众健康构成重大威胁。这些病毒包括黄病毒属的登革热病毒(DENV)和寨卡病毒(ZIKV),以及阿尔法病毒属的基孔肯雅病毒(CHIKV)。蝙蝠在这些病毒属在热带地区从蚊子到人类的传播循环中的潜在作用尚未得到研究。在墨西哥东南部尤卡坦州不同地貌(森林和草地)的地点,使用雾网捕获了属于三个科(Emballonuridae、Phyllostomidae 和 Molossidae)和六个种的 144 只蝙蝠,为期一年。采集的血样、直肠拭子和口腔拭子通过 RT-PCR 检测了黄热病病毒和阿尔法病毒 RNA 基因组。53 人(36.8%;95% CI:29.4%-44.9%)检测到了弗拉维病毒 RNA,59 人(40.1%;95% CI:33.2%-49.2%)检测到了阿尔法病毒 RNA。所获得的序列与黄热病病毒中的 ZIKV 和 DENV 以及阿尔法病毒阳性样本中的 CHIKV 一致。与雨季相比,旱季的黄热病病毒和鹅口疮病毒流行率更高。黄热病毒和阿尔法病毒的高阳性率表明,蝙蝠可能是这些病毒属在草原环境中传播的重要因素。病毒属感染率的季节性变化(旱季比雨季感染率高)可能表明病毒的活动模式与气候条件有关。
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引用次数: 0
Contribution of artificial intelligence for understanding animal rabies epidemiology in Morocco: What are the perspectives of an innovative and predictive approaches? 人工智能对了解摩洛哥动物狂犬病流行病学的贡献:创新预测方法的前景如何?
IF 4.1 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-13 DOI: 10.1016/j.onehlt.2024.100874

Rabies is a major zoonotic disease legally notifiable in Morocco and elsewhere. Given the burden of rabies and its impact on public health, several national control programs have been implemented since 1986, without achieving their expected objectives.

The aim of this study was to design a predictive analysis of rabies in Morocco. The expected outcome was the construction of probabilistic diagrams that can guide actions for the integrated control of this disease, involving all stakeholders, in the country. Such modeling is an essential step in operational epidemiology to optimize expenditure of public funds allocated to the integrated strategy for fighting this disease.

The methodology employed combined the use of geospatial analysis tools (kriging) and artificial intelligence models (Machine Learning). In order to investigate the link between the risk of rabies within a territorial municipality (commune) and its socio-economic situation, the following data were analyzed: (1) health data: reported animal cases of rabies between 2004 and 2021 and data obtained through the ArcGIS kriging tool (Geospatial data); (2) demographic and socio-economic data. We compared several Machine Learning models. Of these, the “Imbalanced-Xgboost” model associated with kriging yielded the best results. After optimizing this model, we mapped our results for better visualization.

The obtained results complement and consolidate previous study in this field with greater accuracy, showing a strong correlation between a commune's socio-economic status, its geographical location and its risk level of rabies. From this, 399 out of the 1546 communes have been identified as high-risk areas, accounting for 25.8% of the total number of communes. Under this risk-based approach, the results of these analyses make it practical to take targeted decisions for rabies prevention and control, as well as canine population control, in a territorial commune according to its risk level. Such an approach allows obvious optimized distribution of financial resources and adaptation of the control actions to be taken.

The study highlights also the importance of using innovative technologies to refine epidemiological approaches and fill gaps in field data. Through this study, we hope to contribute to eradication of rabies in Morocco by providing reliable data and practical recommendations for control actions against rabies.

狂犬病是一种主要的人畜共患疾病,在摩洛哥和其他地方均可依法申报。鉴于狂犬病造成的负担及其对公共卫生的影响,自 1986 年以来已实施了多项国家控制计划,但均未达到预期目标。本研究的目的是对摩洛哥的狂犬病进行预测分析,其预期结果是绘制概率图,为该国涉及所有利益相关方的狂犬病综合控制行动提供指导。这种建模是流行病学操作中的一个重要步骤,可优化分配给该疾病综合防治战略的公共资金的支出。所采用的方法结合使用了地理空间分析工具(克里金法)和人工智能模型(机器学习)。为了研究一个自治市(乡镇)的狂犬病风险与其社会经济状况之间的联系,我们对以下数据进行了分析:(1) 健康数据:2004 年至 2021 年间报告的狂犬病动物病例以及通过 ArcGIS 克里金工具获得的数据(地理空间数据);(2) 人口和社会经济数据。我们比较了几种机器学习模型。其中,与克里金相关的 "不平衡-Xgboost "模型取得了最佳结果。在对该模型进行优化后,我们对结果进行了映射,以便更好地进行可视化。所获得的结果补充和巩固了之前在该领域的研究,并提高了准确性,显示出乡镇的社会经济状况、地理位置和狂犬病风险水平之间存在很强的相关性。由此,1546 个乡镇中有 399 个被确定为高风险地区,占乡镇总数的 25.8%。在这种以风险为基础的方法下,这些分析的结果使得在一个市镇地区根据其风险水平做出有针对性的狂犬病预防和控制以及犬群控制的决定变得切实可行。这项研究还强调了利用创新技术完善流行病学方法和填补实地数据空白的重要性。我们希望通过这项研究,提供可靠的数据和实用的狂犬病控制行动建议,为在摩洛哥根除狂犬病做出贡献。
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引用次数: 0
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