Pub Date : 2025-04-04DOI: 10.1016/j.lanmic.2024.101053
Ouli Xie, Rebecca H Chisholm, Leo Featherstone, An N T Nguyen, Andrew J Hayes, Magnus G Jespersen, Cameron Zachreson, Nefel Tellioglu, Gerry Tonkin-Hill, Ravindra Dotel, Stephanie Spring, Alice Liu, Alexander Rofe, Sebastian Duchene, Norelle L Sherry, Robert W Baird, Vicki L Krause, Deborah C Holt, Lachlan J M Coin, Neela Joshi Rai, Matthew V N O'Sullivan, Katherine Bond, Jukka Corander, Benjamin P Howden, Tony M Korman, Bart J Currie, Steven Y C Tong, Mark R Davies
<p><strong>Background: </strong>Defining the temporal dynamics of invasive Streptococcus pyogenes (group A Streptococcus) and differences between hyperendemic and lower-incidence regions provides crucial insights into pathogen evolution and, in turn, informs preventive measures. We aimed to examine the clinical and temporal lineage dynamics of S pyogenes across different disease settings in Australia to improve understanding of drivers of pathogen diversity.</p><p><strong>Methods: </strong>In this retrospective, multicentre, clinical and genomic epidemiology study, we identified cases of invasive S pyogenes infection from normally sterile sites between Jan 1, 2011, and Feb 28, 2023. Data were collected from five hospital networks across low-incidence regions in temperate southeast Australia and the hyperendemic, tropical, and largely remote Top End of the Northern Territory of Australia. The crude incidence rate ratio (IRR) of bloodstream S pyogenes infection comparing the Top End and southeast Australia and in First Nations people compared with non-First Nations people was estimated by quasi-Poisson regression. We estimated odds ratios (ORs) of intensive care unit (ICU) admission, in-hospital mortality, and 30-day mortality for the Top End versus southeast Australia using logistic regression. Retrieved and successfully sequenced isolates were assigned lineages at whole-genome resolution. Temporal trends in the composition of co-circulating lineages were compared between the two regions. We used an S pyogenes-specific multistrain simulated transmission model to examine the relationship between host population-specific parameters and observed pathogen lineage dynamics. The prevalence of accessory genes (those present in 5-95% of all genomes) was compared across geographies and temporal periods to investigate genomic drivers of diversity.</p><p><strong>Findings: </strong>We identified 500 cases of invasive S pyogenes infection in patients in the Top End and 495 cases in patients in southeast Australia. The crude IRR of bloodstream infection for the Top End compared with southeast Australia was 5·97 (95% CI 4·61-7·73) across the entire study period; in the Top End, infection disproportionately affected First Nations people compared with non-First Nations people (5·41, 4·28-6·89). The odds of in-hospital mortality (OR 0·43, 95% CI 0·26-0·70), 30-day mortality (0·38, 0·23-0·63), and ICU admission (0·42, 0·30-0·59) were lower in the Top End than in southeast Australia. Longitudinal lineage analysis of 642 S pyogenes genomes identified waves of replacement with distinct lineages in the Top End, whereas southeast Australia had a small number of dominant lineages that persisted and cycled in frequency. The transmission model qualitatively reproduced a similar pattern of replacement with distinct lineages when using a high transmission rate, small population size, and high levels of human movement-characteristics similar to those of communities in the hype
{"title":"Temporal and geographical lineage dynamics of invasive Streptococcus pyogenes in Australia from 2011 to 2023: a retrospective, multicentre, clinical and genomic epidemiology study.","authors":"Ouli Xie, Rebecca H Chisholm, Leo Featherstone, An N T Nguyen, Andrew J Hayes, Magnus G Jespersen, Cameron Zachreson, Nefel Tellioglu, Gerry Tonkin-Hill, Ravindra Dotel, Stephanie Spring, Alice Liu, Alexander Rofe, Sebastian Duchene, Norelle L Sherry, Robert W Baird, Vicki L Krause, Deborah C Holt, Lachlan J M Coin, Neela Joshi Rai, Matthew V N O'Sullivan, Katherine Bond, Jukka Corander, Benjamin P Howden, Tony M Korman, Bart J Currie, Steven Y C Tong, Mark R Davies","doi":"10.1016/j.lanmic.2024.101053","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.101053","url":null,"abstract":"<p><strong>Background: </strong>Defining the temporal dynamics of invasive Streptococcus pyogenes (group A Streptococcus) and differences between hyperendemic and lower-incidence regions provides crucial insights into pathogen evolution and, in turn, informs preventive measures. We aimed to examine the clinical and temporal lineage dynamics of S pyogenes across different disease settings in Australia to improve understanding of drivers of pathogen diversity.</p><p><strong>Methods: </strong>In this retrospective, multicentre, clinical and genomic epidemiology study, we identified cases of invasive S pyogenes infection from normally sterile sites between Jan 1, 2011, and Feb 28, 2023. Data were collected from five hospital networks across low-incidence regions in temperate southeast Australia and the hyperendemic, tropical, and largely remote Top End of the Northern Territory of Australia. The crude incidence rate ratio (IRR) of bloodstream S pyogenes infection comparing the Top End and southeast Australia and in First Nations people compared with non-First Nations people was estimated by quasi-Poisson regression. We estimated odds ratios (ORs) of intensive care unit (ICU) admission, in-hospital mortality, and 30-day mortality for the Top End versus southeast Australia using logistic regression. Retrieved and successfully sequenced isolates were assigned lineages at whole-genome resolution. Temporal trends in the composition of co-circulating lineages were compared between the two regions. We used an S pyogenes-specific multistrain simulated transmission model to examine the relationship between host population-specific parameters and observed pathogen lineage dynamics. The prevalence of accessory genes (those present in 5-95% of all genomes) was compared across geographies and temporal periods to investigate genomic drivers of diversity.</p><p><strong>Findings: </strong>We identified 500 cases of invasive S pyogenes infection in patients in the Top End and 495 cases in patients in southeast Australia. The crude IRR of bloodstream infection for the Top End compared with southeast Australia was 5·97 (95% CI 4·61-7·73) across the entire study period; in the Top End, infection disproportionately affected First Nations people compared with non-First Nations people (5·41, 4·28-6·89). The odds of in-hospital mortality (OR 0·43, 95% CI 0·26-0·70), 30-day mortality (0·38, 0·23-0·63), and ICU admission (0·42, 0·30-0·59) were lower in the Top End than in southeast Australia. Longitudinal lineage analysis of 642 S pyogenes genomes identified waves of replacement with distinct lineages in the Top End, whereas southeast Australia had a small number of dominant lineages that persisted and cycled in frequency. The transmission model qualitatively reproduced a similar pattern of replacement with distinct lineages when using a high transmission rate, small population size, and high levels of human movement-characteristics similar to those of communities in the hype","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":" ","pages":"101053"},"PeriodicalIF":20.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-03DOI: 10.1016/j.lanmic.2024.101037
Anke Hemmerling, Caroline M Mitchell, Suuba Demby, Musie Gebremichael, Joseph Elsherbini, Jiawu Xu, Nondumiso Xulu, Johnathan Shih, Krista Dong, Vaneshree Govender, Vanessa Pillay, Nasreen Ismail, Gardenia Casillas, Jayajothi Moodley, Agnes Bergerat, Tess Brunner, Lenine Liebenberg, Sinaye Ngcapu, Ian Mbano, Laurel Lagenaur, Thomas P Parks, Thumbi Ndung'u, Douglas S Kwon, Craig R Cohen
<p><strong>Background: </strong>Absence of vaginal lactobacilli and accompanying genital inflammation is associated with HIV acquisition. We aimed to assess how a vaginal live biotherapeutic containing Lactobacillus crispatus affects cervicovaginal microbiota and markers of HIV susceptibility in South African women.</p><p><strong>Methods: </strong>This randomised, placebo-controlled, phase 2 trial evaluated LACTIN-V (L crispatus CTV-05), a vaginal live biotherapeutic, compared with placebo in cisgender women in South Africa, aged 18-23 years, recruited at a community-based research clinic. Eligible participants with a Nugent score of 4-10 (indicating intermediate vaginal microbiota or bacterial vaginosis) completed 7 days of oral metronidazole and were randomly assigned (2:1) to LACTIN-V (2 × 10<sup>9</sup> colony forming units per dose) or placebo (the substrate alone) via an independently generated randomisation sequence. Pharmacists, participants, and investigators were masked to treatment assignment. The study product (or placebo) was dosed daily for 5 days in week 1, then twice per week for an additional 3 weeks. Adverse events were evaluated 4 weeks and 8 weeks after starting the study product. Vaginal swabs (for 16S rRNA sequencing of the vaginal microbiome) and cervicovaginal lavage (for Luminex analysis of immune markers) were collected before metronidazole treatment, before study product (or placebo) administration, and at the week 4 and week 8 follow-up visits. An endocervical cytobrush for flow cytometry analysis of immune cell populations (including CD3<sup>+</sup>CD4<sup>+</sup> T cells, and presence of CCR5 and the activation markers CD38 or HLA-DR) was collected before study product use and at 4 weeks and 8 weeks after study product use. The coprimary outcomes for the trial were (1) safety and acceptability of LACTIN-V, as measured by number of adverse events and a validated questionnaire; (2) presence of a Lactobacillus-dominant vaginal microbial community by 16S rRNA gene sequencing at week 4 and week 8; and (3) comparison of change in genital tract inflammatory markers from before metronidazole treatment to week 4 and week 8 between groups. Safety analyses were done in the intention-to-treat population and efficacy analyses in a modified intent-to-treat population (ie, excluding one person assigned placebo who erroneously received LACTIN-V). This trial is completed and registered on ClinicalTrials.gov (NCT05022212).</p><p><strong>Findings: </strong>45 Black South African women were randomly assigned to receive LACTIN-V (n=32) or placebo (n=13). One woman in each group discontinued the trial during the intervention and two women discontinued during the follow-up. No severe or serious adverse events were observed. Solicited adverse events occurred in 35 (78%) of 45 participants with no significant difference by group (risk ratio 1·17, 95% CI 0·79-1·75; p=0·44). All local solicited adverse events were mild. 32 (71%) of 45 particip
{"title":"Effect of the vaginal live biotherapeutic LACTIN-V (Lactobacillus crispatus CTV-05) on vaginal microbiota and genital tract inflammation among women at high risk of HIV acquisition in South Africa: a phase 2, randomised, placebo-controlled trial.","authors":"Anke Hemmerling, Caroline M Mitchell, Suuba Demby, Musie Gebremichael, Joseph Elsherbini, Jiawu Xu, Nondumiso Xulu, Johnathan Shih, Krista Dong, Vaneshree Govender, Vanessa Pillay, Nasreen Ismail, Gardenia Casillas, Jayajothi Moodley, Agnes Bergerat, Tess Brunner, Lenine Liebenberg, Sinaye Ngcapu, Ian Mbano, Laurel Lagenaur, Thomas P Parks, Thumbi Ndung'u, Douglas S Kwon, Craig R Cohen","doi":"10.1016/j.lanmic.2024.101037","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.101037","url":null,"abstract":"<p><strong>Background: </strong>Absence of vaginal lactobacilli and accompanying genital inflammation is associated with HIV acquisition. We aimed to assess how a vaginal live biotherapeutic containing Lactobacillus crispatus affects cervicovaginal microbiota and markers of HIV susceptibility in South African women.</p><p><strong>Methods: </strong>This randomised, placebo-controlled, phase 2 trial evaluated LACTIN-V (L crispatus CTV-05), a vaginal live biotherapeutic, compared with placebo in cisgender women in South Africa, aged 18-23 years, recruited at a community-based research clinic. Eligible participants with a Nugent score of 4-10 (indicating intermediate vaginal microbiota or bacterial vaginosis) completed 7 days of oral metronidazole and were randomly assigned (2:1) to LACTIN-V (2 × 10<sup>9</sup> colony forming units per dose) or placebo (the substrate alone) via an independently generated randomisation sequence. Pharmacists, participants, and investigators were masked to treatment assignment. The study product (or placebo) was dosed daily for 5 days in week 1, then twice per week for an additional 3 weeks. Adverse events were evaluated 4 weeks and 8 weeks after starting the study product. Vaginal swabs (for 16S rRNA sequencing of the vaginal microbiome) and cervicovaginal lavage (for Luminex analysis of immune markers) were collected before metronidazole treatment, before study product (or placebo) administration, and at the week 4 and week 8 follow-up visits. An endocervical cytobrush for flow cytometry analysis of immune cell populations (including CD3<sup>+</sup>CD4<sup>+</sup> T cells, and presence of CCR5 and the activation markers CD38 or HLA-DR) was collected before study product use and at 4 weeks and 8 weeks after study product use. The coprimary outcomes for the trial were (1) safety and acceptability of LACTIN-V, as measured by number of adverse events and a validated questionnaire; (2) presence of a Lactobacillus-dominant vaginal microbial community by 16S rRNA gene sequencing at week 4 and week 8; and (3) comparison of change in genital tract inflammatory markers from before metronidazole treatment to week 4 and week 8 between groups. Safety analyses were done in the intention-to-treat population and efficacy analyses in a modified intent-to-treat population (ie, excluding one person assigned placebo who erroneously received LACTIN-V). This trial is completed and registered on ClinicalTrials.gov (NCT05022212).</p><p><strong>Findings: </strong>45 Black South African women were randomly assigned to receive LACTIN-V (n=32) or placebo (n=13). One woman in each group discontinued the trial during the intervention and two women discontinued during the follow-up. No severe or serious adverse events were observed. Solicited adverse events occurred in 35 (78%) of 45 participants with no significant difference by group (risk ratio 1·17, 95% CI 0·79-1·75; p=0·44). All local solicited adverse events were mild. 32 (71%) of 45 particip","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":" ","pages":"101037"},"PeriodicalIF":20.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-02DOI: 10.1016/j.lanmic.2025.101131
Akaninyene Otu, Vinesh Patel, Stuart Bond, Sarah Chadwick, Bassey Ebenso, Mamoon Aldeyab, Jade Lee-Milner, Victoria Hemming, Kathyrn Deakin, Maria Marcolin
{"title":"The intersection of socioeconomic deprivation and antimicrobial resistance: refocusing on a key determinant.","authors":"Akaninyene Otu, Vinesh Patel, Stuart Bond, Sarah Chadwick, Bassey Ebenso, Mamoon Aldeyab, Jade Lee-Milner, Victoria Hemming, Kathyrn Deakin, Maria Marcolin","doi":"10.1016/j.lanmic.2025.101131","DOIUrl":"https://doi.org/10.1016/j.lanmic.2025.101131","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":" ","pages":"101131"},"PeriodicalIF":20.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.lanmic.2024.100984
Meagan E Deming MD PhD , Prof Elizabeth R Brown ScD , Monica A McArthur MD PhD , Stephanie J Schrag DPhil , Melissa Arvay PhD , Mike Humphrys MS , Prof Jacques Ravel PhD , Jeffrey Adelglass MD , Brandon Essink MD , David B Musante MD , Rebecca Maguire MPH , Richard Gorman MD , Elizabeth Formentini MSN MBA , Robin Mason MS MBA , Merlin L Robb MD , Prof Kathleen M Neuzil MD MPH , Rekha R Rapaka MD PhD , Peter Wolff MHA , Prof Karen L Kotloff MD , Michael Waters
<div><h3>Background</h3><div>Although existing COVID-19 vaccines are known to be highly effective against severe disease and death, data are needed to assess their ability to reduce SARS-CoV-2 infection. We aimed to estimate the efficacy of the NVX-CoV2373 protein subunit vaccine against SARS-CoV-2 infection, regardless of symptoms, among adolescents.</div></div><div><h3>Methods</h3><div>We performed an ancillary observational study (SNIFF) to the phase 3, observer-blinded, randomised, placebo-controlled PREVENT-19 trial that assessed vaccine efficacy against symptomatic COVID-19 in the USA. Participants in the PREVENT-19 trial included healthy adolescents aged 12–17 years and with no history of laboratory-confirmed SARS-CoV-2 infection. They were randomly assigned (2:1) to receive either the NVX-CoV2373 (Novavax, Gaithersburg, MD, USA) vaccine (immediate NVX-CoV2373 group) or placebo (delayed NVX-CoV2373 group) on days 0 and 21 (initial series). After 2 months, in a crossover series, participants received two doses, 21 days apart, of the intervention that they did not receive in their initial series. Participants at 47 of the PREVENT-19 sites were invited to participate in the SNIFF study and self-collect nasal swabs at home twice weekly for SARS-CoV-2 testing to assess vaccine efficacy against SARS-CoV-2 infection. This primary outcome was defined as the first identification of SARS-CoV-2 detected by RT-PCR, regardless of symptoms, with onset within 4 weeks after the second dose of the initial vaccination series until the second dose of the crossover series. Secondary outcomes were vaccine efficacy against asymptomatic and minimally symptomatic SARS-CoV-2 infection, durability of vaccine efficacy against SARS-CoV-2 infection, and durability of vaccine efficacy against asymptomatic and minimally symptomatic infections. Outcomes were analysed in the modified intention-to-treat population, which included all participants without previous SARS-CoV-2 infection and was restricted to participants enrolled within 4 weeks of the second dose of the primary (primary analysis population) or crossover (post-crossover analysis population) series. This study is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT04611802</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Between June 1 and Dec 17, 2021, 1196 (53·2%) of the 2247 adolescent participants recruited in the PREVENT-19 trial enrolled in the SNIFF study. The primary analysis population included 471 participants in the immediate NVX-CoV2373 group and 220 in the delayed NVX-CoV2373 group. Incidence of SARS-CoV-2 infection was 14·9 cases per 100 person-years (95% CI 7·9–25·5) in the immediate group and 54·2 cases per 100 person-years (33·6–82·9) in the delayed group; vaccine efficacy was 73·5% (95% CI 47·1–86·7; p=0·0002). Incidence of minimally symptomatic or asymptomatic SARS-CoV-2 infection was 10·3 cases per 100 person-years
{"title":"Vaccine efficacy of NVX-CoV2373 against SARS-CoV-2 infection in adolescents in the USA: an ancillary study to a phase 3, observer-blinded, randomised, placebo-controlled trial","authors":"Meagan E Deming MD PhD , Prof Elizabeth R Brown ScD , Monica A McArthur MD PhD , Stephanie J Schrag DPhil , Melissa Arvay PhD , Mike Humphrys MS , Prof Jacques Ravel PhD , Jeffrey Adelglass MD , Brandon Essink MD , David B Musante MD , Rebecca Maguire MPH , Richard Gorman MD , Elizabeth Formentini MSN MBA , Robin Mason MS MBA , Merlin L Robb MD , Prof Kathleen M Neuzil MD MPH , Rekha R Rapaka MD PhD , Peter Wolff MHA , Prof Karen L Kotloff MD , Michael Waters","doi":"10.1016/j.lanmic.2024.100984","DOIUrl":"10.1016/j.lanmic.2024.100984","url":null,"abstract":"<div><h3>Background</h3><div>Although existing COVID-19 vaccines are known to be highly effective against severe disease and death, data are needed to assess their ability to reduce SARS-CoV-2 infection. We aimed to estimate the efficacy of the NVX-CoV2373 protein subunit vaccine against SARS-CoV-2 infection, regardless of symptoms, among adolescents.</div></div><div><h3>Methods</h3><div>We performed an ancillary observational study (SNIFF) to the phase 3, observer-blinded, randomised, placebo-controlled PREVENT-19 trial that assessed vaccine efficacy against symptomatic COVID-19 in the USA. Participants in the PREVENT-19 trial included healthy adolescents aged 12–17 years and with no history of laboratory-confirmed SARS-CoV-2 infection. They were randomly assigned (2:1) to receive either the NVX-CoV2373 (Novavax, Gaithersburg, MD, USA) vaccine (immediate NVX-CoV2373 group) or placebo (delayed NVX-CoV2373 group) on days 0 and 21 (initial series). After 2 months, in a crossover series, participants received two doses, 21 days apart, of the intervention that they did not receive in their initial series. Participants at 47 of the PREVENT-19 sites were invited to participate in the SNIFF study and self-collect nasal swabs at home twice weekly for SARS-CoV-2 testing to assess vaccine efficacy against SARS-CoV-2 infection. This primary outcome was defined as the first identification of SARS-CoV-2 detected by RT-PCR, regardless of symptoms, with onset within 4 weeks after the second dose of the initial vaccination series until the second dose of the crossover series. Secondary outcomes were vaccine efficacy against asymptomatic and minimally symptomatic SARS-CoV-2 infection, durability of vaccine efficacy against SARS-CoV-2 infection, and durability of vaccine efficacy against asymptomatic and minimally symptomatic infections. Outcomes were analysed in the modified intention-to-treat population, which included all participants without previous SARS-CoV-2 infection and was restricted to participants enrolled within 4 weeks of the second dose of the primary (primary analysis population) or crossover (post-crossover analysis population) series. This study is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (<span><span>NCT04611802</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Between June 1 and Dec 17, 2021, 1196 (53·2%) of the 2247 adolescent participants recruited in the PREVENT-19 trial enrolled in the SNIFF study. The primary analysis population included 471 participants in the immediate NVX-CoV2373 group and 220 in the delayed NVX-CoV2373 group. Incidence of SARS-CoV-2 infection was 14·9 cases per 100 person-years (95% CI 7·9–25·5) in the immediate group and 54·2 cases per 100 person-years (33·6–82·9) in the delayed group; vaccine efficacy was 73·5% (95% CI 47·1–86·7; p=0·0002). Incidence of minimally symptomatic or asymptomatic SARS-CoV-2 infection was 10·3 cases per 100 person-years","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 100984"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.lanmic.2024.101036
Rajesh Parsanathan
{"title":"Reassessing the role of butyrate-producing bacteria in infection risk","authors":"Rajesh Parsanathan","doi":"10.1016/j.lanmic.2024.101036","DOIUrl":"10.1016/j.lanmic.2024.101036","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 101036"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite increased awareness and public health initiatives, the incidence of microbial infections related to tattoos has increased since 2000. Building on the first paper in this two-part Series, which detailed the microbiological aspects of tattoo-related infections over the past two centuries from 1820 to 2023, this second paper describes the patterns, causes, and other related epidemiological factors of these infections. Since 2000, bacterial outbreaks, particularly those caused by non-tuberculous mycobacteria, have increased, prompting a re-evaluation of tattoos as a serious public health risk. Insufficient hygiene practices have been the primary cause of microbial infections, with contaminated tattoo inks also contributing substantially, leading to 11 outbreaks and subsequent ink recalls. Although rare, the tattooing process can occasionally lead to life-threatening infections and fatalities. Tattoos by both professional and non-professional artists were associated with infections, suggesting that regulated environments do not necessarily eliminate risk. Additionally, individuals with compromised immune systems, especially those with HIV, were particularly vulnerable to infections such as Leishmania. Although permanent make-up is often perceived as safer than conventional tattoos, infections still occur, with 11 cases reported since 2010. Furthermore, polymicrobial infections involving multiple pathogens have posed challenges for diagnosis and treatment. Overall, these insights highlight the historical and emerging patterns of tattoo-related infections and can inform the development of more effective public health guidelines, enhance preventive measures, and guide future research on reducing the risks associated with tattoos.
{"title":"Causes, patterns, and epidemiology of tattoo-associated infections since 1820","authors":"Sunghyun Yoon PhD , Sandeep Kondakala PhD , Soumana Daddy-Gaoh PhD , Steven Foley PhD , Ohgew Kweon PhD , Seong-Jae Kim PhD","doi":"10.1016/j.lanmic.2024.101006","DOIUrl":"10.1016/j.lanmic.2024.101006","url":null,"abstract":"<div><div>Despite increased awareness and public health initiatives, the incidence of microbial infections related to tattoos has increased since 2000. Building on the first paper in this two-part Series, which detailed the microbiological aspects of tattoo-related infections over the past two centuries from 1820 to 2023, this second paper describes the patterns, causes, and other related epidemiological factors of these infections. Since 2000, bacterial outbreaks, particularly those caused by non-tuberculous mycobacteria, have increased, prompting a re-evaluation of tattoos as a serious public health risk. Insufficient hygiene practices have been the primary cause of microbial infections, with contaminated tattoo inks also contributing substantially, leading to 11 outbreaks and subsequent ink recalls. Although rare, the tattooing process can occasionally lead to life-threatening infections and fatalities. Tattoos by both professional and non-professional artists were associated with infections, suggesting that regulated environments do not necessarily eliminate risk. Additionally, individuals with compromised immune systems, especially those with HIV, were particularly vulnerable to infections such as <em>Leishmania</em>. Although permanent make-up is often perceived as safer than conventional tattoos, infections still occur, with 11 cases reported since 2010. Furthermore, polymicrobial infections involving multiple pathogens have posed challenges for diagnosis and treatment. Overall, these insights highlight the historical and emerging patterns of tattoo-related infections and can inform the development of more effective public health guidelines, enhance preventive measures, and guide future research on reducing the risks associated with tattoos.</div></div>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 101006"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.lanmic.2024.100987
Scott Jones PhD , Bethany Hicks BSc , Helen Callaby MRCP , Daniel Bailey PhD , N Claire Gordon DPhil , Tommy Rampling DPhil , Catherine Houlihan PhD , Rachael Jones FRCP , Marcus Pond PhD , Ravi Mehta MRCP , Deborah Wright PGDip , Clarissa Oeser PhD , Simon Tonge MSc , Ezra Linley PhD , Cathy Rowe MSc , Bassam Hallis PhD , Ashley Otter PhD
Background
In May, 2022, the first global outbreak of mpox (formerly known as monkeypox) occurred. In response, public health agencies in the UK have made smallpox vaccines available to individuals at the highest risk of infection. With mpox cases still being detected globally, novel tools are required to aid with diagnosis, serosurveillance, and the evaluation of immune responses following infection and immunisation with current and new vaccine candidates. Here, we describe the development of a multiplexed immunoassay, MpoxPlex, able to measure IgG responses to 12 Orthopoxvirus antigens concurrently and distinguish between responses to infection and vaccination.
Methods
Using the Luminex (DiaSorin, Saluggia, Italy) platform, antibody responses to vaccinia virus (VACV) antigens B5, A27, and A33 and monkeypox virus (MPXV) antigens E8, B6, B2, M1, A27, A35, H3, A29, and A5 were assessed in serum from individuals after MPXV infection (n=24) and after vaccination (n=75) with modified VACV Ankara-Bavarian Nordic. Assay characteristics and cutoffs were calculated by fitting receiver operating characteristic curves to the median fluorescence intensities of these positive samples and negative samples that were run alongside (n=435). P values were calculated using non-parametric Mann–Whitney, Kruskal–Wallis, and Dunn’s multiple comparisons tests.
Findings
Using the results from a combination of eight antigens, we were able to distinguish samples as either post-vaccination or post-infection from negative samples with a sensitivity of 98% and a specificity of 95%. IgG responses to MPXV antigen A27 were able to distinguish post-MPXV infection with a sensitivity of 88% and a specificity of 97%. VACV antigen A27 and MPXV antigens A29 and A5 provided little diagnostic advantage.
Interpretation
With additional benefits over current serological assays, we believe this assay will provide substantial insight into the current global outbreak of mpox. MpoxPlex shows use for both serosurveillance and immunological studies of vaccination and infection.
Funding
Grant-in-aid funding to the Emerging Pathogen Serology Group at Porton Down, UK Health Security Agency.
{"title":"Assessment of MpoxPlex, a high-throughput and multiplexed immunoassay: a diagnostic accuracy study","authors":"Scott Jones PhD , Bethany Hicks BSc , Helen Callaby MRCP , Daniel Bailey PhD , N Claire Gordon DPhil , Tommy Rampling DPhil , Catherine Houlihan PhD , Rachael Jones FRCP , Marcus Pond PhD , Ravi Mehta MRCP , Deborah Wright PGDip , Clarissa Oeser PhD , Simon Tonge MSc , Ezra Linley PhD , Cathy Rowe MSc , Bassam Hallis PhD , Ashley Otter PhD","doi":"10.1016/j.lanmic.2024.100987","DOIUrl":"10.1016/j.lanmic.2024.100987","url":null,"abstract":"<div><h3>Background</h3><div>In May, 2022, the first global outbreak of mpox (formerly known as monkeypox) occurred. In response, public health agencies in the UK have made smallpox vaccines available to individuals at the highest risk of infection. With mpox cases still being detected globally, novel tools are required to aid with diagnosis, serosurveillance, and the evaluation of immune responses following infection and immunisation with current and new vaccine candidates. Here, we describe the development of a multiplexed immunoassay, MpoxPlex, able to measure IgG responses to 12 <em>Orthopoxvirus</em> antigens concurrently and distinguish between responses to infection and vaccination.</div></div><div><h3>Methods</h3><div>Using the Luminex (DiaSorin, Saluggia, Italy) platform, antibody responses to vaccinia virus (VACV) antigens B5, A27, and A33 and monkeypox virus (MPXV) antigens E8, B6, B2, M1, A27, A35, H3, A29, and A5 were assessed in serum from individuals after MPXV infection (n=24) and after vaccination (n=75) with modified VACV Ankara-Bavarian Nordic. Assay characteristics and cutoffs were calculated by fitting receiver operating characteristic curves to the median fluorescence intensities of these positive samples and negative samples that were run alongside (n=435). P values were calculated using non-parametric Mann–Whitney, Kruskal–Wallis, and Dunn’s multiple comparisons tests.</div></div><div><h3>Findings</h3><div>Using the results from a combination of eight antigens, we were able to distinguish samples as either post-vaccination or post-infection from negative samples with a sensitivity of 98% and a specificity of 95%. IgG responses to MPXV antigen A27 were able to distinguish post-MPXV infection with a sensitivity of 88% and a specificity of 97%. VACV antigen A27 and MPXV antigens A29 and A5 provided little diagnostic advantage.</div></div><div><h3>Interpretation</h3><div>With additional benefits over current serological assays, we believe this assay will provide substantial insight into the current global outbreak of mpox. MpoxPlex shows use for both serosurveillance and immunological studies of vaccination and infection.</div></div><div><h3>Funding</h3><div>Grant-in-aid funding to the Emerging Pathogen Serology Group at Porton Down, UK Health Security Agency.</div></div>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"6 4","pages":"Article 100987"},"PeriodicalIF":20.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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