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Shigella and childhood stunting: Evidence, gaps, and future research directions. 志贺菌与儿童发育迟缓:证据、差距和未来研究方向。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-12 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011475
Karoun H Bagamian, John D Anderson Iv, Gabriela Blohm, Suzanne Scheele

Early childhood growth deficits have been shown to have lifelong health and economic impacts, yet their connection to one of their underlying causes, diarrheal diseases, has remained difficult to characterize. Identifying the processes and mechanisms that underlie this link has remained a challenge due to the complexity of the relationship and limitations in access to more advanced laboratory methods. In recent years, however, several large-scale, multisite studies have extensively investigated and reported the prevalence, etiology, and impacts of diarrheal diseases in children under 5 years (CU5) in low- to middle-income countries (LMICs). These studies, in combination with several single-site studies, have applied more advanced laboratory methods to uncover the etiology, true prevalence, infection mechanisms, and inflammation biomarkers of diarrheal disease. Of the multiple pathogens that have been shown to be strongly associated with diarrheal disease in CU5, Shigella is one of the more prevalent and impactful of these pathogens. In this narrative review, we highlight key insights from these studies and identify knowledge gaps and directions for future research. According to these studies, Shigella is most commonly detected in toddlers and young children; however, it can cause more severe disease and has a greater impact on linear growth for infants. Shigella often has a stronger relationship to linear growth faltering (LGF) than other enteropathogens, with higher Shigella loads resulting in greater growth deficits. Future studies should employ more Shigella-specific molecular assays and identify diarrheal etiologies using standardized diagnostics to improve child anthropometric and Shigella surveillance. Also, they should focus on uncovering the mechanisms of the relationship underlying Shigella and growth faltering to better characterize the role of asymptomatic infections and intestinal inflammation in this relationship.

幼儿生长发育缺陷已被证明对终身健康和经济有影响,但其与其根本原因之一腹泻疾病的联系仍难以确定。由于这种关系的复杂性以及获得更先进的实验室方法的局限性,确定这种联系背后的过程和机制仍然是一个挑战。然而,近年来,几项大规模的多站点研究广泛调查和报道了中低收入国家(LMIC)5岁以下儿童腹泻疾病的流行率、病因和影响。这些研究与几项单点研究相结合,应用了更先进的实验室方法来揭示腹泻病的病因、真实患病率、感染机制和炎症生物标志物。在CU5中已被证明与腹泻病密切相关的多种病原体中,志贺菌是这些病原体中最常见和影响最大的一种。在这篇叙述性综述中,我们强调了这些研究的关键见解,并确定了未来研究的知识差距和方向。根据这些研究,志贺菌最常见于学步儿童和幼儿;然而,它会导致更严重的疾病,并对婴儿的线性生长产生更大的影响。与其他肠道病原体相比,志贺氏菌通常与线性生长迟缓(LGF)有更强的关系,较高的志贺氏杆菌载量会导致更大的生长缺陷。未来的研究应采用更多志贺菌特异性分子测定法,并使用标准化诊断法确定腹泻病因,以改进儿童人体测量和志贺菌监测。此外,他们应该专注于揭示志贺菌和生长迟缓之间的关系机制,以更好地描述无症状感染和肠道炎症在这种关系中的作用。
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引用次数: 0
Prevalence of soil-transmitted helminths and associated risk factors among primary school children in Kandahar, Afghanistan: A cross-sectional analytical study. 阿富汗坎大哈小学生中土壤传播蠕虫的患病率及相关风险因素:一项横断面分析研究。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-11 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011614
Bilal Ahmad Rahimi, Najeebullah Rafiqi, Zarghoon Tareen, Khalil Ahmad Kakar, Mohammad Hashim Wafa, Muhammad Haroon Stanikzai, Mohammad Asim Beg, Abdul Khaliq Dost, Walter R Taylor

Background: Soil-transmitted helminth (STH) infections are global health problem, especially in low-income countries. Main objectives of this study were to estimate the prevalence and intensity of STH and its risk factors among school children in Kandahar city of Afghanistan.

Methodology/principal findings: This was a school-based cross-sectional analytical study, with data collected during eight-month-period (May-December, 2022) from 6- and 12-years old school children in Kandahar city, Afghanistan. All the stool samples were examined by saline wet mount method and Kato-Katz technique. Data were analyzed by using descriptive statistics, Chi square test, and multivariate logistic regression. A total of 1275 children from eight schools of Kandahar city were included in this study. Mean age of these children was 8.3 years with 53.3% boys. The overall prevalence of any intestinal parasitic infection was 68.4%. The overall prevalence of STH infection was 39.1%, with Ascaris lumbricoides (29.4%) as the most prevalent STH species. Mean intensity of overall STH infection was 97.8. Multivariate logistic regression revealed playing barefoot (AOR 1.6, 95% CI 1.1-2.2), not washing hands after defecating and before eating (AOR 1.3, 95% CI 1.0-1.7), having untrimmed nails (AOR 1.4, 95% CI 1.1-1.8), and belonging to poor families (AOR 1.3, 95% CI 1.0-1.7) as the risk factors associated with the predisposition of school children for getting STH in Kandahar city of Afghanistan.

Conclusions/significance: There is high prevalence of STH among school children of Kandahar city in Afghanistan. Most of the risk factors are related to poverty, decreased sanitation, and improper hygiene. Improvement of socioeconomic status, sanitation, and health education to promote public awareness about health and hygiene together with periodic mass deworming programs are better strategies for the control of STH infections in Afghanistan.

背景:土壤传播的蠕虫感染是全球性的健康问题,尤其是在低收入国家。本研究的主要目的是估计阿富汗坎大哈市学童STH的患病率和强度及其风险因素。方法/主要发现:这是一项基于学校的横断面分析研究,数据收集于阿富汗坎大哈市6岁和12岁学童的8个月期间(2022年5月至12月)。所有粪便样品均采用盐水湿悬法和Kato-Katz技术进行检查。采用描述性统计、卡方检验和多变量逻辑回归对数据进行分析。这项研究共包括来自坎大哈市八所学校的1275名儿童。这些儿童的平均年龄为8.3岁,其中男孩占53.3%。肠道寄生虫感染的总患病率为68.4%。STH感染的总发病率为39.1%,其中蛔虫(29.4%)是最常见的STH物种。STH总感染的平均强度为97.8。多因素logistic回归显示,赤脚(AOR 1.6,95%CI 1.1-2.2),排便后和进食前不洗手(AOR 1.3,95%CI 1.0-1.7),指甲未修剪(AOR 1.4,95%CI 1.11-1.8),和属于贫困家庭(AOR 1.3,95%CI 1.0-1.7)是与阿富汗坎大哈市学童患STH倾向相关的风险因素。结论/意义:阿富汗坎大哈市的学童STH患病率很高。大多数风险因素与贫困、卫生条件差和不适当的个人卫生有关。改善社会经济地位、环境卫生和健康教育,以提高公众对健康和个人卫生的认识,以及定期实施大规模驱虫计划,是控制阿富汗STH感染的更好策略。
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引用次数: 0
Molecular characterization of a novel serine proteinase from Trichinella spiralis and its participation in larval invasion of gut epithelium. 旋毛虫一种新型丝氨酸蛋白酶的分子特征及其参与幼虫对肠上皮的侵袭。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-11 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011629
Yan Yan Song, Xin Zhuo Zhang, Bo Ning Wang, Min Min Weng, Zhao Yu Zhang, Xin Guo, Xi Zhang, Zhong Quan Wang, Jing Cui

Background: A novel serine proteinase of Trichinells spiralis (TsSPc) has been identified in the excretion/secretion (ES) antigens, but its role in larval invasion is unclear. The aim of this study was to clone and express TsSPc, identify its biological and biochemical characteristics, and investigate its role on larval invasion of gut epithelium during T. spiralis infection.

Methodology/principal findings: TsSPc has a functional domain of serine proteinase, and its tertiary structure consists of three amino acid residues (His88, Asp139 and Ser229) forming a pocket like functional domain. Recombinant TsSPc (rTsSPc) was expressed and purified. The rTsSPc has good immunogenicity. On Western blot analysis, rTsSPc was recognized by infection serum and anti-rTsSPc serum, natural TsSPc in crude and ES antigens was identified by anti-rTsSPc serum. The results of qPCR, Western blot and indirect immunofluorescence test (IIFT) showed that TsSPc was expressed at diverse stage worms, and mainly localized at cuticle, stichosome and intrauterine embryos of this nematode. The rTsSPc had enzymatic activity of native serine protease, which hydrolyzed the substrate BAEE, casein and collagen I. After site directed mutation of enzymatic active sites of TsSPc, its antigenicity did not change but the enzyme activity was fully lost. rTsSPc specifically bound to intestinal epithelium cells (IECs) and the binding sites were mainly localized in cell membrane and cytoplasm. rTsSPc accelerated larval invasion of IECs, whereas anti-rTsSPc antibodies and TsSPc-specific dsRNA obviously hindered larval invasion.

Conclusions: TsSPc was a surface and secretory proteinase of the parasite, participated in larval invasion of gut epithelium, and may be considered as a candidate vaccine target molecule against Trichinella intrusion and infection.

背景:旋毛虫排泄/分泌(ES)抗原中发现了一种新型丝氨酸蛋白酶(TsSPc),但其在幼虫入侵中的作用尚不清楚。本研究的目的是克隆和表达TsSPc,鉴定其生物学和生化特性,并研究其在旋毛虫感染过程中对幼虫侵袭肠道上皮的作用。方法论/主要发现:TsSPc具有丝氨酸蛋白酶的功能结构域,其三级结构由三个氨基酸残基(His88、Asp139和Ser229)组成,形成口袋状功能结构域。表达并纯化了重组TsSPc(rTsSPc)。rtSPc具有良好的免疫原性。在Western印迹分析中,rtSPc被感染血清和抗rTsSPc血清识别,粗品中的天然TsSPc和ES抗原被抗rTsSPc血清识别。qPCR、Western blot和间接免疫荧光试验(IIFT)结果表明,TsSPc在不同阶段的蠕虫中均有表达,主要定位于该线虫的角质层、缝合体和宫内胚胎。rTsSPc具有天然丝氨酸蛋白酶的酶活性,可水解底物BAEE、酪蛋白和I型胶原。TsSPc酶活性位点的定点突变后,其抗原性没有改变,但酶活性完全丧失。rtSPc与肠上皮细胞特异性结合,结合位点主要定位于细胞膜和细胞质。rtSPc加速了IECs对幼虫的入侵,而抗rTSPc抗体和TsSPc特异性dsRNA明显阻碍了幼虫的入侵。结论:TsSPc是一种寄生虫的表面分泌型蛋白酶,参与幼虫对肠上皮的侵袭,可作为旋毛虫入侵和感染的候选疫苗靶分子。
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引用次数: 0
Evaluation of models for multi-step forecasting of hand, foot and mouth disease using multi-input multi-output: A case study of Chengdu, China. 使用多输入多输出的手足口病多步骤预测模型的评估:以中国成都为例。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-08 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011587
Xiaoran Geng, Yue Ma, Wennian Cai, Yuanyi Zha, Tao Zhang, Huadong Zhang, Changhong Yang, Fei Yin, Tiejun Shui

Background: Hand, foot and mouth disease (HFMD) is a public health concern that threatens the health of children. Accurately forecasting of HFMD cases multiple days ahead and early detection of peaks in the number of cases followed by timely response are essential for HFMD prevention and control. However, many studies mainly predict future one-day incidence, which reduces the flexibility of prevention and control.

Methods: We collected the daily number of HFMD cases among children aged 0-14 years in Chengdu from 2011 to 2017, as well as meteorological and air pollutant data for the same period. The LSTM, Seq2Seq, Seq2Seq-Luong and Seq2Seq-Shih models were used to perform multi-step prediction of HFMD through multi-input multi-output. We evaluated the models in terms of overall prediction performance, the time delay and intensity of detection peaks.

Results: From 2011 to 2017, HFMD in Chengdu showed seasonal trends that were consistent with temperature, air pressure, rainfall, relative humidity, and PM10. The Seq2Seq-Shih model achieved the best performance, with RMSE, sMAPE and PCC values of 13.943~22.192, 17.880~27.937, and 0.887~0.705 for the 2-day to 15-day predictions, respectively. Meanwhile, the Seq2Seq-Shih model is able to detect peaks in the next 15 days with a smaller time delay.

Conclusions: The deep learning Seq2Seq-Shih model achieves the best performance in overall and peak prediction, and is applicable to HFMD multi-step prediction based on environmental factors.

背景:手足口病(HFMD)是一种威胁儿童健康的公共卫生问题。提前几天准确预测手足口病病例,及早发现病例数的峰值并及时做出反应,对于手足口病的预防和控制至关重要。然而,许多研究主要预测未来一天的发病率,这降低了预防和控制的灵活性。方法:收集2011-2017年成都市0-14岁儿童手足口病日发病数,以及同期气象和大气污染物数据。LSTM、Seq2Seq、Seq2Seq Luong和Seq2Seq-Shih模型用于通过多输入多输出进行手足口病的多步骤预测。我们根据整体预测性能、检测峰值的时间延迟和强度对模型进行了评估。结果:2011-2017年,成都手足口病呈现出与温度、气压、降雨量、相对湿度和PM10一致的季节性趋势。Seq2Seq Shih模型的性能最好,2天至15天的预测RMSE、sMAPE和PCC值分别为13.943~22.192、17.880~27.937和0.887~0.705。同时,Seq2Seq Shih模型能够以较小的时间延迟检测到未来15天的峰值。结论:深度学习Seq2Seq Shih模型在总体预测和峰值预测方面表现最好,适用于基于环境因素的手足口病多步预测。
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引用次数: 0
Temporal changes in pathology and viral RNA distribution in guinea pigs following separate infection with two New World Arenaviruses. 豚鼠分别感染两种新世界阿海那韦后病理学和病毒RNA分布的时间变化。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-08 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011620
Curtis Cline, Xiankun Zeng, Todd M Bell, Carl Shaia, Paul Facemire, Janice Williams, Neil Davis, April Babka, Edwin Picado, Colin Fitzpatrick, Joseph W Golden

Numerous arenaviruses have been identified throughout the Americas and a subset of these viruses cause viral hemorrhagic fever in humans. This study compared the pathology and viral RNA distribution in Hartley guinea pigs challenged with two human-disease causing New World arenaviruses, Junin virus (JUNV) or Guanarito virus (GTOV). Histopathologic analysis and RNA in situ hybridization revealed similar pathology and viral RNA distribution for both groups of animals challenged with either JUNV or GTOV on days 3, 7, 10 and 12 post exposure (PE). Gross lesions were first observed on day 7 and primarily involved the lungs and liver. The most severe histologic lesions occurred in the lymph nodes, spleen, and thymus and included lymphoid depletion and necrosis which increased in severity over time. Extensive necrosis was also observed in the bone marrow on day 12. Minimal to mild inflammation with and without necrosis was observed in the choroid plexus of the brain, choroid of the eye, intestinal tract, lung and adrenal gland. Significant liver lesions were rare, consisting predominantly of hepatocyte vacuolation. Viral RNA labeling was identified in nearly all organs examined, was often extensive in certain organs and generally increased over time starting on day 7. Our data demonstrate the guinea pig may serve as a useful model to study New World arenavirus infection in humans and for the evaluation and development of medical countermeasures.

在整个美洲已经发现了许多竞技场病毒,其中一部分病毒会导致人类病毒性出血热。本研究比较了用两种人类致病的新世界竞技场病毒Junin病毒(JUNV)或Guanarito病毒(GTOV)攻击的Hartley豚鼠的病理学和病毒RNA分布。组织病理学分析和RNA原位杂交显示,在暴露后第3、7、10和12天(PE),用JUNV或GTOV攻击的两组动物的病理学和病毒RNA分布相似。在第7天首次观察到大体病变,主要涉及肺部和肝脏。最严重的组织学损伤发生在淋巴结、脾脏和胸腺,包括淋巴耗竭和坏死,其严重程度随着时间的推移而增加。在第12天,在骨髓中也观察到广泛的坏死。在大脑脉络丛、眼睛脉络丛、肠道、肺和肾上腺中观察到有或没有坏死的轻微至轻度炎症。显著的肝脏病变是罕见的,主要由肝细胞空泡组成。在几乎所有检查的器官中都发现了病毒RNA标记,在某些器官中通常是广泛的,并且通常从第7天开始随着时间的推移而增加。我们的数据表明,豚鼠可能是研究新世界人类竞技场病毒感染以及评估和制定医疗对策的有用模型。
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引用次数: 0
Adipokine levels and their association with clinical disease severity in patients with dengue. 登革热患者的脂肪因子水平及其与临床疾病严重程度的关系。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-07 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011613
Heshan Kuruppu, W P Rivindu H Wickramanayake, Chandima Jeewandara, Deneshan Peranantharajah, H S Colambage, Lahiru Perera, Laksiri Gomes, Ananda Wijewickrama, Graham S Ogg, Gathsaurie Neelika Malavige

Adipokines have not been studied in acute dengue, despite their emerging role in inducing and regulating inflammation. Therefore, we sought to identify adipokine levels in patients with varying severities of acute dengue to understand their role in disease pathogenesis. We determined the levels of leptin, resistin, omentin, adiponectin, as well as IFNβ, and NS1 using quantitative ELISA in patients with dengue fever (DF = 49) and dengue haemorrhagic fever (DHF = 22) at admission (febrile phase) and at the time of discharge (recovery phase). The viral loads and serotypes of all samples were quantified using quantitative real-time RT-PCR. Resistin levels (p = 0.04) and omentin (p = 0.006) levels were significantly higher in patients who developed DHF. Omentin levels in the febrile phase also correlated with the AST (Spearman's r = 0.38, p = 0.001) and ALT levels (Spearman's r = 0.24, p = 0.04); as well as serum leptin levels with both AST (Spearman's r = 0.27, p = 0.02) and ALT (Spearman's r = 0.28, p = 0.02). Serum adiponectin levels in the febrile phase did not correlate with any of the other adipokines or with liver enzymes, but inversely correlated with CRP levels (Spearman's r = -0.31, p = 0.008). Although not significant (p = 0.14) serum IFNβ levels were lower in the febrile phase in those who progressed to develop DHF (median 0, IQR 0 to 39.4 pg/ml), compared to those who had DF (median 37.1, IQR 0 to 65.6 pg.ml). The data suggest that adipokines are likely to play a role in the pathogenesis of dengue, which should be further explored for the potential to be used as prognostic markers and as therapeutic targets.

尽管脂肪因子在诱导和调节炎症方面发挥着新的作用,但尚未对其在急性登革热中的作用进行研究。因此,我们试图确定不同严重程度急性登革热患者的脂肪因子水平,以了解它们在疾病发病机制中的作用。我们使用定量ELISA测定了登革热(DF=49)和登革出血热(DHF=22)患者入院时(发热期)和出院时(恢复期)的瘦素、抵抗素、网膜蛋白、脂联素以及IFNβ和NS1的水平。使用定量实时RT-PCR对所有样本的病毒载量和血清型进行定量。DHF患者的抵抗素水平(p=0.04)和网膜蛋白水平(p=0.006)显著升高。发热期的Omentin水平也与AST(Spearman’s r=0.38,p=0.001)和ALT水平(Spearman's r=0.24,p=0.04)相关;以及血清瘦素水平与AST(Spearman’s r=0.27,p=0.02)和ALT(Spearman's r=0.28,p=0.02)。发热期的血清脂联素水平与任何其他脂肪因子或肝酶无关,但与CRP水平呈负相关(Spearman’s r=-0.31,p=0.008)。尽管不显著(p=0.14),但与DF患者(中位数37.1,IQR 0至65.6 pg.ml)相比,进展为DHF的患者在发热期的血清IFNβ水平较低(中位数0,IQR为0至39.4 pg/ml)。数据表明,脂肪因子可能在登革热的发病机制中发挥作用,应进一步探索其作为预后标志物和治疗靶点的潜力。
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引用次数: 0
Case series of 12 Bartonella quintana endocarditis from the Southwest Indian Ocean. 来自西南印度洋的12例五尖巴尔杆菌心内膜炎病例系列。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-07 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011606
Ludivine Sarsiat, Thomas Garrigos, Linda Houhamdi, Olivier Dauwalder, Barbara Kuli, Eric Braunberger, Olivier Belmonte, Pierre-Edouard Fournier, Guillaume Miltgen

Background: Bartonella spp. are fastidious bacteria frequently identified as the cause of blood culture-negative (BCN) endocarditis. However, Bartonella infections are difficult to diagnose in routine laboratory testing and their incidence is probably underestimated. We investigated the epidemiological and clinical features of Bartonella endocarditis cases diagnosed between 2009 and 2021 on Reunion Island (Southwest Indian Ocean).

Method: We retrospectively included all patients diagnosed with Bartonella endocarditis at Reunion Island University Hospital during this period. Endocarditis was diagnosed on the basis of microbiological findings, including serological tests (IFA) and PCR on cardiac valves, and the modified Duke criteria. We used then the multispacer typing (MST) method to genotype the available Bartonella strains.

Findings: We report 12 cases of B. quintana endocarditis on Reunion Island (83.3% in men, median patient age: 32 years). All the patients originated from the Comoros archipelago. The traditional risk factors for B. quintana infection (homelessness, alcoholism, exposure to body lice) were absent in all but two of the patients, who reported head louse infestations in childhood. Previous heart disease leading to valve dysfunction was recorded in 50% of patients. All patients underwent cardiac valve surgery and antimicrobial therapy with a regimen including doxycycline. All patients presented high C-reactive protein concentrations, anemia and negative blood cultures. The titer of IgG antibodies against Bartonella sp. exceeded 1:800 in 42% of patients. Specific PCR on cardiac valves confirmed the diagnosis of B. quintana endocarditis in all patients. Genotyping by the MST method was performed on four strains detected in preserved excised valves and was contributive for three, which displayed the MST6 genotype.

Conclusions: Bartonella quintana is an important cause of infective endocarditis in the Comoros archipelago and should be suspected in patients with mitral valve dysfunction and BCN from this area.

背景:巴尔杆菌是一种挑剔的细菌,经常被确定为血液培养阴性(BCN)心内膜炎的病因。然而,巴尔杆菌感染很难在常规实验室检测中诊断,其发病率可能被低估了。我们调查了2009年至2021年在留尼汪岛(西南印度洋)诊断的巴尔onella心内膜炎病例的流行病学和临床特征。方法:我们回顾性纳入了在此期间在留尼旺岛大学医院诊断为巴尔onella心内膜炎的所有患者。心内膜炎是根据微生物学检查结果诊断的,包括对心脏瓣膜的血清学检测(IFA)和PCR,以及改良的杜克标准。然后,我们使用多间隔分型(MST)方法对可用的巴尔onella菌株进行基因分型。研究结果:我们报告了留尼汪岛12例昆塔氏杆菌心内膜炎(83.3%为男性,患者中位年龄:32岁)。所有患者均来自科摩罗群岛。除两名患者外,其他所有患者都没有感染昆塔线虫的传统风险因素(无家可归、酗酒、接触体虱),这些患者报告了儿童时期的头虱感染。50%的患者曾患过导致瓣膜功能障碍的心脏病。所有患者均接受了心脏瓣膜手术和包括多西环素在内的抗菌药物治疗。所有患者均表现为C反应蛋白浓度高、贫血和血培养阴性。在42%的患者中,针对巴尔通菌的IgG抗体滴度超过1:800。对心脏瓣膜的特异性聚合酶链式反应证实了所有患者的B.quintana心内膜炎诊断。通过MST方法对在保存的切除瓣膜中检测到的4株菌株进行了基因分型,并对显示MST6基因型的3株菌株做出了贡献。结论:在科摩罗群岛感染性心内膜炎的一个重要病因是五尖巴尔杆菌,该地区的二尖瓣功能障碍和BCN患者应予以怀疑。
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引用次数: 0
Coverage evaluation of mass drug administration with triple drug regimen in an evaluation unit in Nagpur district of Maharashtra, India. 在印度马哈拉施特拉邦那格浦尔区的一个评估单位,用三种药物方案进行大规模药物管理的覆盖率评估。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-07 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011588
Raja Jeyapal Dinesh, Adinarayanan Srividya, Swaminathan Subramanian, Kaliannagounder Krishnamoorthy, Shanmugavelu Sabesan, Monika Charmode Raghorte, Ashwani Kumar, Purushothaman Jambulingam
Background Triple drug regimen (IDA; Ivermectin, Diethylcarbamazine, Albendazole) recommended for accelerating elimination of lymphatic filariasis was launched in India in December 2018. Nagpur district in Maharashtra was one of the first five districts where this strategy was introduced. The National Vector Borne Disease Control Programme (NVBDCP) at the district reported ~85.0% treatment coverage in the first round of mass drug administration (MDA) with IDA implemented in EU-2 in Nagpur district in January 2019. As per the national guideline, a coverage evaluation survey was carried out and both quantitative and qualitative data were collected to assess the treatment coverage, the level of community preparation and identify the gaps, if any, for improvement. Methodology A Coverage Evaluation Survey (CES) following the WHO recommended protocol was conducted in one of the two evaluation units (EU-2) in Nagpur district in March 2019. Coverage Sample Builder (CSB) V2.9 tool was used to calculate the sample size, select sites and estimate drug coverage. The CSB tool followed a two-stage cluster sampling procedure to select 30 primary sampling units (ward/village as a cluster) and a list of random numbers for selecting households (HHs) in each cluster. The results were analyzed for operational indicators. Stata ver. 14.0 software was used to construct the 95% confidence limits accounting for clustering. Results A total of 1601 individuals aged 5–85 years of both gender from 328 HHs were surveyed from the 30 randomly selected clusters in EU-2. The mean age was 33.8±17.6 years. Among the surveyed population, 78.0% received the drugs (programme reach) and 66.1% consumed the drugs (survey coverage). Survey coverage was significantly higher in rural (82.6%) than in urban (59.4%) and peri-urban (58.6%) areas (P<0.001). Directly observed treatment (DOT) among the surveyed population was 51.6%. Adverse events were reported among 6.9% respondents who reported to have consumed the drugs. Conclusion The IDA based MDA strategy could achieve just the required level of treatment coverage (~65%) in EU-2, Nagpur district, which had previously undergone several rounds of DA-MDAs (Diethylcarbamazine, Albendazole). Having achieved an effective treatment coverage of >80% in rural areas, the coverage in urban and peri-urban areas need to be improved in order to attain the impact of IDA-MDA. It is imperative to strengthen drug delivery and community preparation activities along with improved DOT especially in urban and peri-urban areas to achieve the required level of treatment coverage. Addition of ivermectin did not have any additional perceived adverse events.
背景:2018年12月,印度启动了加速消除淋巴丝虫病的三重药物方案(IDA;伊维菌素、二乙基氨基甲嗪、阿苯达唑)。马哈拉施特拉邦的那格浦尔区是首批引入这一战略的五个区之一。该地区的国家病媒传播疾病控制计划(NVBDCP)报告称,在2019年1月那格浦尔地区EU-2实施的IDA第一轮大规模药物管理(MDA)中,治疗覆盖率约为85.0%。根据国家指南,进行了覆盖率评估调查,收集了定量和定性数据,以评估治疗覆盖率、社区准备水平,并确定需要改进的差距(如果有的话)。方法:根据世界卫生组织建议的方案,于2019年3月在那格浦尔区两个评估单位之一(EU-2)进行了覆盖率评估调查(CES)。覆盖率样本生成器(CSB)V2.9工具用于计算样本量、选择位点和估计药物覆盖率。CSB工具遵循两阶段整群抽样程序,选择30个主要抽样单位(作为一个整群的病房/村庄)和一份随机数列表,用于在每个整群中选择家庭。对结果进行了操作指标分析。Stata第14.0版软件用于构建95%的置信限,以解释聚类。结果:从EU-2中随机选择的30个集群中,共调查了来自328个HH的1601名5-85岁的男女个体。平均年龄33.8±17.6岁。在接受调查的人群中,78.0%的人接受了药物(计划覆盖范围),66.1%的人服用了药物(调查覆盖范围)。农村地区(82.6%)的调查覆盖率显著高于城市地区(59.4%)和城市周边地区(58.6%)(P结论:在那格浦尔区的欧盟2区,基于IDA的MDA策略可以达到所需的治疗覆盖率水平(~65%),该区此前已进行了几轮DA MDA(二乙基氨基甲嗪、阿苯达唑)。在农村地区实现了>80%的有效治疗覆盖率后,需要提高城市和城市周边地区的覆盖率,以达到IDA-MDA的影响。必须加强药物交付和社区准备活动,同时改善DOT,特别是在城市和城郊地区,以达到所需的治疗覆盖水平。添加伊维菌素没有任何额外的不良事件。
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引用次数: 0
Exploring the antimicrobial peptidome of nematodes through phylum-spanning in silico analyses highlights novel opportunities for pathogen control. 通过跨门的计算机分析探索线虫的抗菌肽组,为病原体控制提供了新的机会。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-06 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011618
Allister Irvine, Sharon A Huws, Louise E Atkinson, Angela Mousley

Antimicrobial Peptides (AMPs) are key constituents of the invertebrate innate immune system and provide critical protection against microbial threat. Nematodes display diverse life strategies where they are exposed to heterogenous, microbe rich, environments highlighting their need for an innate immune system. Within the Ecdysozoa, arthropod AMPs have been well characterised, however nematode-derived AMP knowledge is limited. In this study the distribution and abundance of putative AMP-encoding genes was examined in 134 nematode genomes providing the most comprehensive profile of AMP candidates within phylum Nematoda. Through genome and transcriptome analyses we reveal that phylum Nematoda is a rich source of putative AMP diversity and demonstrate (i) putative AMP group profiles that are influenced by nematode lifestyle where free-living nematodes appear to display enriched putative AMP profiles relative to parasitic species; (ii) major differences in the putative AMP profiles between nematode clades where Clade 9/V and 10/IV species possess expanded putative AMP repertoires; (iii) AMP groups with highly restricted profiles (e.g. Cecropins and Diapausins) and others [e.g. Nemapores and Glycine Rich Secreted Peptides (GRSPs)] which are more widely distributed; (iv) complexity in the distribution and abundance of CSαβ subgroup members; and (v) that putative AMPs are expressed in host-facing life stages and biofluids of key nematode parasites. These data indicate that phylum Nematoda displays diversity in putative AMPs and underscores the need for functional characterisation to reveal their role and importance to nematode biology and host-nematode-microbiome interactions.

抗菌肽(AMPs)是无脊椎动物先天免疫系统的关键成分,可提供抵御微生物威胁的关键保护。线虫表现出不同的生活策略,它们暴露在异质的、富含微生物的环境中,这突出了它们对先天免疫系统的需求。在Ecdysozoa中,节肢动物AMP已经得到了很好的表征,但线虫衍生的AMP知识有限。在这项研究中,在134个线虫基因组中检测了推定的AMP编码基因的分布和丰度,提供了线虫门内最全面的AMP候选图谱。通过基因组和转录组分析,我们揭示了线虫门是推定AMP多样性的丰富来源,并证明了(i)受线虫生活方式影响的推定AMP组谱,其中自由生活的线虫似乎显示出相对于寄生物种丰富的推定AMP谱;(ii)线虫分支之间推定AMP图谱的主要差异,其中分支9/V和10/IV物种具有扩大的推定AMP库;(iii)具有高度限制性图谱的AMP基团(例如Cecropins和Diapausins)和分布更广泛的其他基团[例如Nemapores和富含甘氨酸的分泌肽(GRPS)];(iv)CSαβ亚群成员分布和丰度的复杂性;和(v)假定的AMP在主要线虫寄生虫的面向宿主的生命阶段和生物流体中表达。这些数据表明,线虫门在假定的AMP中表现出多样性,并强调了功能表征的必要性,以揭示其在线虫生物学和宿主-线虫-微生物组相互作用中的作用和重要性。
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引用次数: 0
A cross-sectional investigation of Leptospira at the wildlife-livestock interface in New Zealand. 新西兰野生动物与牲畜交界处钩端螺旋体的横断面调查。
IF 3.8 2区 医学 Q1 Medicine Pub Date : 2023-09-06 eCollection Date: 2023-09-01 DOI: 10.1371/journal.pntd.0011624
Marie Moinet, Hedwich Oosterhof, Shahista Nisa, Neville Haack, David A Wilkinson, Danielle Aberdein, James C Russell, Emilie Vallée, Julie Collins-Emerson, Cord Heuer, Jackie Benschop

There has been a recent upsurge in human cases of leptospirosis in New Zealand, with wildlife a suspected emerging source, but up-to-date knowledge on this topic is lacking. We conducted a cross-sectional study in two farm environments to estimate Leptospira seroprevalence in wildlife and sympatric livestock, PCR/culture prevalence in wildlife, and compare seroprevalence and prevalence between species, sex, and age groups. Traps targeting house mice (Mus musculus), black rats (Rattus rattus), hedgehogs (Erinaceus europaeus) and brushtail possums (Trichosurus vulpecula) were set for 10 trap-nights in March-April 2017 on a dairy (A) and a beef and sheep (B) farm. Trapped wild animals and an age-stratified random sample of domestic animals, namely cattle, sheep and working dogs were blood sampled. Sera were tested by microagglutination test for five serogroups and titres compared using a Proportional Similarity Index (PSI). Wildlife kidneys were sampled for culture and qPCR targeting the lipL32 gene. True prevalence in mice was assessed using occupancy modelling by collating different laboratory results. Infection profiles varied by species, age group and farm. At the MAT cut-point of ≥ 48, up to 78% of wildlife species, and 16-99% of domestic animals were seropositive. Five of nine hedgehogs, 23/105 mice and 1/14 black rats reacted to L. borgpetersenii sv Ballum. The sera of 4/18 possums and 4/9 hedgehogs reacted to L. borgpetersenii sv Hardjobovis whilst 1/18 possums and 1/9 hedgehogs reacted to Tarassovi. In ruminants, seroprevalence for Hardjobovis and Pomona ranged 0-90% and 0-71% depending on the species and age group. Titres against Ballum, Tarassovi and Copenhageni were also observed in 4-20%, 0-25% and 0-21% of domestic species, respectively. The PSI indicated rodents and livestock had the most dissimilar serological responses. Three of nine hedgehogs, 31/105 mice and 2/14 rats were carrying leptospires (PCR and/or culture positive). True prevalence estimated by occupancy modelling in mice was 38% [95% Credible Interval 26, 51%] on Farm A and 22% [11, 40%] on Farm B. In the same environment, exposure to serovars found in wildlife species was commonly detected in livestock. Transmission pathways between and within species should be assessed to help in the development of efficient mitigation strategies against Leptospira.

最近,新西兰的人类钩端螺旋体病病例激增,野生动物被怀疑是新出现的来源,但缺乏有关这一主题的最新知识。我们在两个农场环境中进行了一项横断面研究,以估计野生动物和有症状牲畜的钩端螺旋体血清流行率、野生动物的PCR/培养流行率,并比较不同物种、性别和年龄组的血清流行率和流行率。2017年3月至4月,在一个奶牛场(a)和一个牛羊场(B)设置了针对家鼠(Mus musculus)、黑鼠(Rattus Rattus)、刺猬(Erinaceus europaeus)和刷尾负鼠(Trichosurus vulpecula)的10个陷阱之夜。对被捕获的野生动物和年龄分层的家畜(即牛、羊和工作犬)进行血液采样。通过微凝集试验检测五个血清组的血清,并使用比例相似指数(PSI)比较滴度。对野生动物肾脏进行取样,用于培养和靶向lipL32基因的qPCR。通过整理不同的实验室结果,使用占用模型评估小鼠的真实患病率。感染情况因物种、年龄组和农场而异。在MAT切割点≥48时,高达78%的野生动物和16-99%的家畜呈血清阳性。9只刺猬中有5只、23/105只小鼠和1/14只黑鼠对L.borgpetersenii sv Ballum有反应。4/18只负鼠和4/9只刺猬的血清对L.borgpetersenii sv Hardjobovis有反应,而1/18只负猴和1/9只刺猬对Tarassovi有反应。在反刍动物中,哈氏和波莫纳的血清流行率在0-90%和0-71%之间,具体取决于物种和年龄组。针对Ballum、Tarassovi和Copenhageni的滴度也分别在4-20%、0-25%和0-21%的国内物种中观察到。PSI表明啮齿动物和牲畜的血清学反应最为不同。9只刺猬中有3只、31/105只小鼠和2/14只大鼠携带钩端螺旋体(PCR和/或培养阳性)。通过小鼠入住模型估计的真实患病率在农场A为38%[95%可信区间26,51%],在农场B为22%[11,40%]。在相同的环境中,在牲畜中通常检测到接触野生动物中发现的血清变异株。应评估物种之间和物种内部的传播途径,以帮助制定针对钩端螺旋体的有效缓解策略。
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