Pathogens and Global Health最新文献

Mpox is a zoonotic viral disease caused by the Monkeypox virus (MPXV). Human cases have been mainly restricted to the African continent until the worldwide multi-country outbreak unfolded in 2022. We reconstructed epidemiological links of 53 MPXV infections using genomic epidemiology in Rio Grande do Sul State, southern Brazil, during 2022 and 2023. We detected five well-supported clades, three representing local transmission chains that were mostly restricted to the 2022 virus spread, one supported year-long maintenance encompassing samples from 2022 and 2023, and one new importation from Europe in 2023. Our results provide new insights into the geographic extent of community transmission and its association with viral diversity during the more pronounced 2022 mpox upsurge and during the following lower incidence phase. These findings highlight the power of continued genomic surveillance to uncover hidden transmission chains to understand viral dynamics and inform public health responses. The detection of sustained transmission in the state is important to guide targeted control measures to curtail further community and international transmission and highlight the need for maintaining genomic surveillance efforts.

Acinetobacter baumannii is a multidrug-resistant bacterium that has emerged as a significant nosocomial pathogen globally and renowned for its ability to acquire antimicrobial resistance (AMR) genes. However, understanding of its resistance mechanisms to certain drug classes remains limited. This study focused on four bacterial strains (AB863, AB889, AB930, and AB960) exhibiting carbapenem resistance. They demonstrated high minimum inhibitory concentration (MIC) (128 mg/L) to meropenem and were categorized as extensively drug-resistant strains. Subsequently, they were identified as A. baumannii through 16S rRNA gene sequence analysis and species-specific PCR targeting the bla_OXA51-like gene. Three strains were sequenced for their genomes to study the genetic determinants and functional relevance of carbapenem resistance. The draft genome length of the strains ranged from 3.8 to 4.0 Mbp. A total of 16 antibiotic resistance genes including the genes bla_OXA-23 and bla_OXA-66 which mediate carbapenem resistance were identified in the genomes. A comprehensive multilocus sequence typing analysis involving 95 A. baumannii strains from different Asian countries assigned the four strains to sequence type 2 (ST2), the most predominant ST circulating in Asia. Comparative genome analysis also revealed bla_OXA-66 as the most dominant variant of bla_OXA-51-like gene and also a widespread distribution of bla_OXA-23 gene. In addition, various mobile genetic elements associated with AMR genes and three efflux pumps families were detected in the genomes of the strains. Transformation of bla_OXA-23 and bla_OXA-66 genes resulted in meropenem resistance in the transformant which exhibited a MIC of 2 mg/L, thus confirming direct involvement of both genes in carbapenem resistance.

The coronavirus disease 2019 (COVID-19) pandemic has disrupted polio immunization programs worldwide. The consequences of these programs' suspension were not fully presented during the COVID-19 pandemic, as some take time to present in a population. We conducted a narrative review to provide a perspective of current literature on the effect of the COVID-19 pandemic on efforts made for poliomyelitis eradication. An overview of potential risks of polio outbreaks and areas where wild and vaccine-derived polioviruses have been reported will be presented in this review. Decreased vaccination rate, human and financial resources diversion to tackle COVID-19, and polio surveillance suspension during the COVID-19 pandemic contributed to creating an immunity gap and increasing the risk of polio outbreaks in at-risk areas. Approaches for integrating immunization efforts with educating the general population, engaging religious leaders, and solving gender disparities to fill the gap that have been made during the pandemic. The path to control polio should engage different levels of policy-making, and governments of affected countries play crucial roles. Strong interdisciplinary collaboration and dedicated efforts are needed to inform policymakers and encourage the public to follow vaccination programs.

Diphtheria is a reemerging vaccine-preventable infection of public health concern. Pooled estimates of serum IgG anti-diphtheria antibody levels can assist in estimating the susceptible population. The objective was to estimate pooled estimate of protective IgG anti-diphtheria antibodies in population globally. We searched three databases until May 2023. We included studies reporting serum anti-diphtheria antibody titre > 0.1 IU/ml as seroprotection. NHLBI checklist was used for quality assessment. Heterogeneity was explored and resolved by statistical methods. 1720 articles were retrieved out of which 51 articles were included. The pooled seropositivity rate against diphtheria was 57%. After removal of two influential outlier studies, pooled seropositivity became 51%. The meta-regression results for age depicted that seroprevalence significantly decreased with increasing age. Subgroup analysis done on basis of geographical distribution significantly reduced heterogeneity and revealed that the Western Pacific region and African regions had lower seroprotectivity compared to other regions. Subgrouping done based on year of sample collection revealed seroprotection was lower (55.63%) between 1986 and 2005 which increased to 67.11% between 2006 and 2015 and again dropped to 45.75% between 2016 and 2023. We concluded that after 2015, the disease has reemerged globally, with seroprotection level below 50% (45.75%) and overall only half of the population being seroprotected against diphtheria. So, there is a need for reinforcement of immunity against diphtheria (supplementary vaccination) after screening for antibody titre. PROSPERO registration number CRD42023458131.

Dengue virus (DENV) remains one of the most common arboviral infections threatening humans. This study was conducted to systematically review the available literature and provide an updated overview of the overall prevalence of DENV infection in Saudi Arabia. The prevalence data was pooled from 21,891 participants recruited in 17 studies. Using random-effects model, the overall prevalence of DENV infection in Saudi Arabia was calculated as 30.8% (95% CI: 20.8-49.8%). The pooled IgM and IgG seroprevalence rates were 17.7% and 26.6%, respectively. Furthermore, the detection of DENV-NS1 antigen and viral RNA revealed pooled estimates of 16.4% and 37.0%, respectively. This study reports a relatively high burden of DENV infection in Saudi Arabia. The findings of this SRMA provide valuable information on the epidemiology of DENV infections in the country, highlighting the need for additional epidemiological investigations to assess the current situation of DENV infection in the country.

Antibiotic resistance in typhoid fever poses a critical public health problem due to the emergence of extensively drug-resistant (XDR) Salmonella, resulting in prolonged illness and treatment failure. Salmonella enterica serovar Typhi is the most predominant among all serotypes and can acquire resistance. The emergence of XDR Salmonella in various regions globally, particularly Pakistan, presents a concerning trend. However, limited data availability impedes a comprehensive understanding of the outbreaks and hinders the development of real-time solutions. Here, we have provided an updated overview of the current outbreaks of XDR Salmonella in epidemic and endemic regions. Treatments of XDR Salmonella infections are challenging, as there are records of treatment failure in humans and animals. However, intensive prevention techniques can be implemented pending the advent of novel antibiotics. Emphasis on antimicrobial stewardship and frequent surveillance of the pathogen should be made to keep track of potential outbreaks in both human and animal populations. Although progress is being made to combat XDR Salmonella within some regions, a unified and efficient effort on an international scale is required to curtail the XDR outbreak before it escalates and leads us back to the pre-antibiotic era.

Aspergillus fumigatus-specific IgG is often used as a diagnostic test for chronic pulmonary aspergillosis (CPA), but few studies have evaluated the performance and serology of IgGs from species other than A. fumigatus. In this study, we evaluated the serology and performance of different Aspergillus species-specific IgG antibodies in patients with CPA and at-risk populations and whether different Aspergillus species-specific IgGs could be of clinical utility and aid in the diagnosis of CPA caused by all Aspergillus species. A total of 187 participants were included between 2020 and 2022 (12 with CPA, 75 with old tuberculosis [TB], 45 with active TB and 55 with bronchiectasis). We measured the serum Aspergillus fumigatus, flavus, terreus, niger-specific, and mixed Aspergillus IgG levels (Phadia ImmunoCap). The correlation was the strongest between A. fumigatus and A. niger (Spearman's rank: 0.940), followed by A. niger and A. flavus (Spearman's rank: 0.915). A. terreus-specific IgG was less strongly correlated with the other three Aspergillus species-specific IgG (Spearman's rank: 0.828-0.849). A. flavus (4 of 6, 67%) was the dominant species. Using the at-least-one-positive approach, the highest performance was obtained when A. fumigatus and A. flavus IgGs were used (sensitivity, 0.75; specificity, 0.84). Significant cross-reactivity exists among different Aspergillus-species IgGs although the correlation may be less significant for A. terreus. In addition to the commonly used A. fumigatus IgG test, IgGs specific to local prevalent Aspergillus species may provide additional clinical utility.

Hepatic schistosomiasis is a neglected parasitosis that affects millions of people each year worldwide and leads to high healthcare costs and increased morbidity and mortality in infected humans. It is a disease that has been widely studied in terms of its pathophysiology; therefore, the signaling pathways that lead to liver damage, with the consequent development of liver fibrosis, are now better understood. Research has elucidated the role of soluble egg antigen in the development of hepatic granulomas and liver fibrosis, the signal transducer and activator of transcription 3 and its participation in liver damage, the role of heat shock protein 47 and its involvement in liver fibrosis, the anti-inflammatory effects caused by interleukin-37, and the role of natural killer and natural killer T cells in the development of the disease. Hepatic schistosomiasis can range from simple hepatomegaly to the development of portal hypertension combined with hepatic fibrosis. For diagnostic purposes, a microscopic examination of excreta remains the gold standard; however, abdominal ultrasound has recently taken on an important role in the assessment of liver lesions produced by the parasite. Praziquantel is considered the management drug of choice, and has been associated with a potential preventive antifibrotic effect.