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Additional thoughts on group A streptococci 关于 A 组链球菌的其他想法。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-01 DOI: 10.1016/S2666-5247(24)00099-5
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引用次数: 0
Infections in long-duration space missions 长期太空任务中的感染。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-01 DOI: 10.1016/S2666-5247(24)00098-3

As government space agencies and private companies announce plans for deep space exploration and colonisation, prioritisation of medical preparedness is becoming crucial. Among all medical conditions, infections pose one of the biggest threats to astronaut health and mission success. To gain a comprehensive understanding of these risks, we review the measured and estimated incidence of infections in space, effect of space environment on the human immune system and microbial behaviour, current preventive and management strategies for infections, and future perspectives for diagnosis and treatment. This information will enable space agencies to enhance their comprehension of the risk of infection in space, highlight gaps in knowledge, aid better crew preparation, and potentially contribute to sepsis management in terrestrial settings, including not only isolated or austere environments but also conventional clinical settings.

随着政府太空机构和私营公司宣布深空探索和殖民计划,医疗准备的优先次序变得至关重要。在所有医疗状况中,感染是对宇航员健康和任务成功的最大威胁之一。为了全面了解这些风险,我们回顾了太空感染的测量和估计发生率、太空环境对人体免疫系统和微生物行为的影响、当前的感染预防和管理策略以及未来的诊断和治疗前景。这些信息将帮助航天机构提高对太空感染风险的认识,突出知识差距,帮助乘员做好更充分的准备,并有可能促进地面环境中的败血症管理,不仅包括孤立或严酷的环境,还包括传统的临床环境。
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引用次数: 0
Effect of weekly fever-screening and treatment and monthly RDT testing and treatment on the infectious reservoir of malaria parasites in Burkina Faso: a cluster-randomised trial 布基纳法索每周一次发烧筛查和治疗以及每月一次 RDT 检测和治疗对疟疾寄生虫传染库的影响:分组随机试验。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-01 DOI: 10.1016/S2666-5247(24)00114-9

Background

The majority of Plasmodium spp infections in endemic countries are asymptomatic and a source of onward transmission to mosquitoes. We aimed to examine whether Plasmodium falciparum transmission and malaria burden could be reduced by improving early detection and treatment of infections with active screening approaches.

Methods

In this 18-month cluster randomised study in Sapone, Burkina Faso, households were enrolled and randomly assigned (1:1:1) to one of three groups: group 1 (control) received standard of care only, group 2 received active weekly, at home, fever screening by a community health worker regardless of symptoms, participants with a fever received a rapid diagnostic test (RDT) and treatment if RDT positive, and group 3 received active weekly fever screening (as in group 2) plus a monthly RDT regardless of symptoms, and treatment if RDT positive. Eligible households had a minimum of three eligible residents, one in each age group (<5 years, 5–15 years, and >15 years). The primary outcome was parasite prevalence by quantitative PCR (qPCR) in the end-of-study cross-sectional survey. Secondary outcomes included parasite and gametocyte prevalence and density in all three end-of-season cross-sectional surveys, incidence of infection, and the transmissibility of infections to mosquitoes. This trial was registered at ClinicalTrials.gov (NCT03705624) and is completed.

Findings

A total of 906 individuals from 181 households were enrolled during two phases, and participated in the study. 412 individuals were enrolled between Aug 9 and 17, 2018, and participated in phase 1 and 494 individuals were enrolled between Jan 10 and 31, 2019, in phase 2. In the end-of-study cross-sectional survey (conducted between Jan 13 and 21, 2020), P falciparum prevalence by qPCR was significantly lower in group 3 (29·26%; 79 of 270), but not in group 2 (45·66%; 121 of 265), when compared with group 1 (48·72%; 133 of 273; risk ratio 0·65 [95% CI 0·52–0·81]; p=0·0001). Total parasite and gametocyte prevalence and density were also significantly lower in group 3 in all surveys. The largest differences were seen at the end of the dry season, with gametocyte prevalence 78·4% and predicted transmission potential 98·2% lower in group 3 than in group 1.

Interpretation

Active monthly RDT testing and treatment can reduce parasite carriage and the infectious reservoir of P falciparum to less than 2% when used during the dry season. This insight might inform approaches for malaria control and elimination.

Funding

Bill & Melinda Gates Foundation, European Research Council, and The Netherlands Organization for Scientific Research.

背景:在疟疾流行国家,大多数疟原虫感染是无症状的,也是蚊子传播的源头。我们的目的是研究是否可以通过积极筛查方法改善感染的早期检测和治疗,从而减少恶性疟原虫的传播和疟疾负担:在布基纳法索萨蓬进行的这项为期 18 个月的分组随机研究中,家庭被登记并随机分配(1:1:1)到三组中的一组:第一组(对照组)仅接受标准护理;第二组由社区卫生工作者每周在家中进行一次积极的发烧筛查,无论症状如何,发烧参与者接受快速诊断检测(RDT),如果 RDT 呈阳性,则接受治疗;第三组每周进行一次积极的发烧筛查(与第二组相同),每月进行一次 RDT,无论症状如何,如果 RDT 呈阳性,则接受治疗。符合条件的家庭至少有三名符合条件的居民,每个年龄组(15 岁)有一名。主要结果是研究结束时横断面调查中通过定量 PCR(qPCR)检测的寄生虫感染率。次要结果包括所有三次季末横断面调查中的寄生虫和配子细胞流行率和密度、感染率以及蚊子感染的传播性。该试验已在 ClinicalTrials.gov 注册(NCT03705624),并已完成:共有来自 181 个家庭的 906 人在两个阶段注册并参与了研究。412人于2018年8月9日至17日期间入组,参与了第一阶段的研究;494人于2019年1月10日至31日期间入组,参与了第二阶段的研究。在研究结束时的横断面调查中(2020 年 1 月 13 日至 21 日期间进行),与第 1 组(48-72%;273 人中有 133 人;风险比 0-65 [95% CI 0-52-0-81];p=0-0001)相比,第 3 组(29-26%;270 人中有 79 人)的 qPCR 法氏疟原虫感染率显著降低,但第 2 组(45-66%;265 人中有 121 人)的感染率没有显著降低。在所有调查中,第 3 组的寄生虫和配子细胞总流行率和密度也明显较低。最大的差异出现在旱季末期,第 3 组配子体流行率比第 1 组低 78-4%,预测传播潜力比第 1 组低 98-2%:解读:在旱季积极开展每月一次的 RDT 检测和治疗,可将寄生虫携带率和恶性疟原虫传染库降低到 2% 以下。这一观点可为疟疾控制和消除提供参考:比尔及梅琳达-盖茨基金会、欧洲研究理事会和荷兰科学研究组织。
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引用次数: 0
Host and pathogen factors that influence variability of Mycobacterium tuberculosis lipid body content in sputum from patients with tuberculosis: an observational study 影响肺结核患者痰液中结核分枝杆菌脂质体含量变化的宿主和病原体因素:一项观察性研究。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-01 DOI: 10.1016/S2666-5247(24)00108-3
<div><h3>Background</h3><p>High proportions of <em>Mycobacterium tuberculosis</em> cells in sputum containing triacylglycerol-rich lipid bodies have been shown to be associated with treatment failure or relapse following antituberculous chemotherapy. Although lipid body determination is a potential biomarker for supporting clinical trial and treatment decisions, factors influencing variability in sputum frequencies of lipid body-positive (%LB<sup>+</sup>) <em>M tuberculosis</em> in patients are unknown. We aimed to test our hypothesis that exposure to host-generated NO and <em>M tuberculosis</em> strains are factors associated with differences in sputum %LB<sup>+</sup>.</p></div><div><h3>Methods</h3><p>In this observational study, we determined %LB<sup>+</sup> frequencies before treatment by microscopy in patients with smear-positive tuberculosis from two separate prospective observational study settings (Gondar, Ethiopia, recruited between May 1, 2010, and April 30, 2011, and Fajara, The Gambia, who provided sputum samples before treatment between May 5, 2010, and Dec 22, 2011). In Ethiopia, fractional exhaled nitric oxide (FeNO) was measured as a biomarker of host NO, and <em>M tuberculosis</em> strain differences were determined by spoligotyping. Treatment response was assessed by percentage weight change after 7 months. In The Gambia, treatment responses were assessed as change in BMI and radiographic burden of disease after 6 months. Sputum <em>M tuberculosis</em> isolates were studied in vitro for their %LB<sup>+</sup> and triacylglycerol synthase 1 (<em>tgs1</em>) mRNA responses to NO exposure. Propidium iodide staining was used as a measure of NO strain toxicity. Correlation between in vitro %LB<sup>+</sup> frequencies following NO exposure and those of the same strain in sputum was examined with linear regression and Dunnett’s multiple comparison test.</p></div><div><h3>Findings</h3><p>In Ethiopia, 73 patients who were smear positive for pulmonary tuberculosis were recruited (43 [59%] were male and 30 [41%] were female). Of these, the %LB<sup>+</sup> in the sputum of 59 patients showed linear correlation with log<sub>10</sub> FeNO (<em>r</em><sup>2</sup>=0·28; p<0·0001) and an association with strain spoligotype was suggested. Seven <em>M tuberculosis</em> strains from The Gambia showed different dose-responses to NO in vitro, demonstrated by changing lipid body content, <em>tgs1</em> transcription, and bacterial toxicity. In sputum %LB<sup>+</sup> frequencies correlated with in vitro %LB<sup>+</sup> responses to NO of the corresponding isolate. In a subset of 34 patients across both cohorts, higher sputum %LB<sup>+</sup> frequencies before treatment were associated with weaker responses to treatment than lower sputum %LB<sup>+</sup> frequencies.</p></div><div><h3>Interpretation</h3><p><em>M tuberculosis</em> strain and exposure to host-generated NO are associated with sputum %LB<sup>+</sup>. Our results support the use of <em>M tuber
背景:研究表明,痰中含有富含三酰甘油脂质体的结核分枝杆菌细胞比例高与抗结核化疗失败或复发有关。虽然脂质体测定是支持临床试验和治疗决策的潜在生物标志物,但影响患者痰中脂质体阳性(%LB+)结核杆菌频率变化的因素尚不清楚。我们的目的是验证我们的假设,即暴露于宿主产生的 NO 和结核菌株是与痰中 LB+ % 的差异相关的因素:在这项观察性研究中,我们通过显微镜检查确定了涂片阳性肺结核患者在治疗前的 LB+ %频率,这些患者来自两个不同的前瞻性观察研究机构(埃塞俄比亚贡德尔,招募时间为 2010 年 5 月 1 日至 2011 年 4 月 30 日;冈比亚法加拉,治疗前提供痰样的时间为 2010 年 5 月 5 日至 2011 年 12 月 22 日)。在埃塞俄比亚,测量了作为宿主一氧化氮生物标志物的呼出一氧化氮分数(FeNO),并通过孢子分型确定了结核杆菌株的差异。治疗反应根据 7 个月后体重变化的百分比进行评估。在冈比亚,治疗反应是根据 6 个月后体重指数和放射学疾病负担的变化来评估的。在体外研究了痰中结核杆菌分离物的 LB+ % 和三酰甘油合成酶 1 (tgs1) mRNA 对 NO 暴露的反应。碘化丙啶染色被用来衡量 NO 菌株的毒性。通过线性回归和邓尼特多重比较试验检验了暴露于 NO 后的体外 LB+ 频率与痰中同一菌株的 LB+ 频率之间的相关性:在埃塞俄比亚,共招募了 73 名涂片阳性的肺结核患者(男性 43 人 [59%],女性 30 人 [41%])。其中,59 名患者痰中的 LB+ % 与 log10 FeNO 呈线性相关(r2=0-28;p+ 频率与相应分离株的体外 LB+ % 对 NO 的反应相关)。在两个队列的 34 名患者中,治疗前痰中 LB+ 百分比频率较高的患者对治疗的反应比痰中 LB+ 百分比频率较低的患者弱:结核杆菌菌株和接触宿主产生的氮氧化物与痰液中的 LB+ 相关。我们的研究结果支持将结核杆菌株依赖性痰液LB+作为治疗反应的预测性生物标志物:医学研究委员会、莱斯特大学和贡德尔大学。
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引用次数: 0
SARS-CoV-2 detection and genomic surveillance: moving to ensure accessible tools in low-income and middle-income countries SARS-CoV-2 检测和基因组监测:努力确保低收入和中等收入国家能够使用这些工具。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-01 DOI: 10.1016/S2666-5247(24)00128-9
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引用次数: 0
Global wastewater surveillance for pathogens with pandemic potential: opportunities and challenges. 对具有流行潜力的病原体进行全球废水监测:机遇与挑战。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-30 DOI: 10.1016/j.lanmic.2024.07.002
Nicholas C Grassly, Alexander G Shaw, Michael Owusu

Wastewater surveillance holds great promise as a sensitive method to detect spillover of zoonotic infections and early pandemic emergence, thereby informing risk mitigation and public health response. Known viruses with pandemic potential are shed in human stool or urine, or both, and the experiences with SARS-CoV-2, monkeypox virus, and Zika virus highlight the feasibility of community-based wastewater surveillance for pandemic viruses that have different transmission routes. We reviewed human shedding and wastewater surveillance data for prototype viruses representing viral families of concern to estimate the likely sensitivity of wastewater surveillance compared with that of clinical surveillance. We examined how data on wastewater surveillance detection, together with viral genetic sequences and animal faecal biomarkers, could be used to identify spillover infections or early human transmission and adaptation. The opportunities and challenges associated with global wastewater surveillance for the prevention of pandemics are described in this Personal View, focusing on low-income and middle-income countries, where the risk of pandemic emergence is the highest. We propose a research and public health agenda to ensure an equitable and sustainable solution to these challenges.

废水监测作为一种灵敏的方法,在检测人畜共患病的外溢和早期大流行病的出现方面大有可为,从而为降低风险和公共卫生应对措施提供信息。已知的具有大流行潜能的病毒会在人类粪便或尿液中脱落,或同时在粪便和尿液中脱落,SARS-CoV-2、猴痘病毒和寨卡病毒的经验突出表明,对具有不同传播途径的大流行病毒进行基于社区的废水监测是可行的。我们回顾了代表受关注病毒家族的原型病毒的人类脱落和废水监测数据,以估计废水监测与临床监测相比可能具有的敏感性。我们研究了如何将废水监测检测数据与病毒基因序列和动物粪便生物标志物一起用于识别外溢感染或早期人类传播和适应。本个人观点阐述了全球废水监测为预防大流行病带来的机遇和挑战,重点关注中低收入国家,因为这些国家出现大流行病的风险最高。我们提出了一项研究和公共卫生议程,以确保公平、可持续地解决这些挑战。
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引用次数: 0
Endemicity and diversification of Morganella spp and carbapenemase-producing Morganella spp. 摩根氏菌属和产碳青霉烯酶摩根氏菌属的地方性和多样化
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-29 DOI: 10.1016/j.lanmic.2024.100970
Xi Li, Jiayao Yao, Longjie Zhou, Hua Zhou, Jintao He
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引用次数: 0
Tackling antimicrobial resistance: recognising the proposed five blind spots can accelerate progress. 应对抗菌药耐药性:认识拟议的五个盲点可加快进展。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-28 DOI: 10.1016/j.lanmic.2024.100968
Madhukar Pai, Sumanth Gandra, Poshan Thapa, Sergio Carmona
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引用次数: 0
Geographical distribution of the Cryptococcus gattii species complex: a systematic review. 加特隐球菌复合菌种的地理分布:系统综述。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-24 DOI: 10.1016/S2666-5247(24)00161-7
Victoria Poplin, Clarissa Smith, Diego H Caceres, Patricia F Herkert, Olujimi Jegede, George R Thompson, John W Baddley, Ilan S Schwartz, Ryan Kubat, Mark A Deka, Mitsuru Toda, Shawn R Lockhart, Tom Chiller, Ferry Hagen, Nathan C Bahr

The taxonomy of the Cryptococcus gattii species complex continues to evolve, and has been divided into five pathogenic species. The objective of this systematic review was to summarise the geographical distribution of the C gattii species complex and the species within the C gattii species complex. We searched PubMed for articles related to human, animal, ecological, or laboratory-based studies of C gattii species complex isolates with traceable geographical origin published from January, 1970, until September, 2021. Having extracted their geographical origin, we used ArcMap to construct maps according to the highest degree of resolution allowed by their reported taxonomy, to reflect the most likely area of transmission on the basis of published reports of human isolates. 604 such articles were included in the study. This review indicated that although C gattii species complex isolates have been reported globally, understanding their heterogeneous geographical distribution by species can have implications for researchers and clinicians in formulating research questions and considering diagnostic quandaries.

加特隐球菌复合菌种的分类法在不断演变,目前已分为五个致病菌种。本系统综述的目的是总结加特隐球菌复合菌种和加特隐球菌复合菌种中各菌种的地理分布情况。我们在 PubMed 上检索了 1970 年 1 月至 2021 年 9 月期间发表的与人类、动物、生态或实验室研究有关的文章,这些文章涉及可追溯地理来源的 C gattii 菌种复合体分离物。在提取了它们的地理来源后,我们使用 ArcMap 按照其报告的分类法所允许的最高分辨率绘制了地图,以根据已发表的人类分离物报告反映最有可能的传播区域。研究共纳入了 604 篇此类文章。该综述表明,虽然全球都有 C gattii 复合菌种分离物的报道,但了解其不同菌种的地理分布情况对研究人员和临床医生提出研究问题和考虑诊断难题具有重要意义。
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引用次数: 0
Emergence of extensively drug-resistant Pseudomonas aeruginosa ST308 co-producing Klebsiella pneumoniae carbapenemase and New Delhi metallo-β-lactamase in Viet Nam. 越南出现广泛耐药的铜绿假单胞菌 ST308,可同时产生肺炎克雷伯氏菌碳青霉烯酶和新德里金属-β-内酰胺酶。
IF 20.9 1区 生物学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-23 DOI: 10.1016/j.lanmic.2024.100958
Dennis Nurjadi, Truong Nhat My, Lisa Göpel, Sébastien Boutin, Le Huu Song, Thirumalaisamy P Velavan
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引用次数: 0
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