Pub Date : 2025-12-03DOI: 10.1016/j.jmii.2025.12.001
Binghui Huo, Yuxuan Liu, DanDan Wei, Peng Liu, Linping Fan, QiSen Huang, Shanshan Huang, Yang Liu
Objective: The global rise of carbapenem-resistant Klebsiella pneumoniae bloodstream infection (CRKP-BSI) is alarming due to its link to increased morbidity and mortality from limited treatment options. This study evaluated the impact of virulence plasmid carriage on CRKP-BSI mortality.
Methods: A matched case-control study was conducted among 93 CRKP patients, 23 of whom tested positive for virulence plasmids. The clinical and bacterial characteristics of CRKP-induced BSIs with and without virulence plasmids were analyzed.
Results: Virulence plasmids were present in 24.7 % of CRKP strains, with a 61.1 % mortality rate among patients with virulence plasmid-positive CRKP (pV-CRKP) infections. The ST11-KL64 subtype was predominant in Jiangxi Province. Molecular typing revealed pV-CRKP strains primarily had two identical genotypes, yet virulence plasmids were present across various PFGE genotypes, indicating polymorphic distribution. Logistic regression identified community-acquired infection, neurology department admission, and stroke as independent risk factors. G. mellonella and biofilm assays showed most CRKP strains with virulence plasmids exhibited increased virulence, though some strains did not.
Conclusion: Virulence plasmids generally heighten CRKP strain virulence and directly affect the 7-day survival rate. Certain strains carry virulence plasmids without increased virulence. Community-acquired infection, neurology department admission, and stroke are independent risk factors for pV-CRKP strains. The presence of IncFrepB among pV-CRKP may promote the spread of virulence genes in ST11-type CRKP.
{"title":"Clinical features and microbiological analysis of risk factors for mortality among patients with carbapenem-resistant Klebsiella pneumoniae bacteremia: A changing virulence landscape.","authors":"Binghui Huo, Yuxuan Liu, DanDan Wei, Peng Liu, Linping Fan, QiSen Huang, Shanshan Huang, Yang Liu","doi":"10.1016/j.jmii.2025.12.001","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.12.001","url":null,"abstract":"<p><strong>Objective: </strong>The global rise of carbapenem-resistant Klebsiella pneumoniae bloodstream infection (CRKP-BSI) is alarming due to its link to increased morbidity and mortality from limited treatment options. This study evaluated the impact of virulence plasmid carriage on CRKP-BSI mortality.</p><p><strong>Methods: </strong>A matched case-control study was conducted among 93 CRKP patients, 23 of whom tested positive for virulence plasmids. The clinical and bacterial characteristics of CRKP-induced BSIs with and without virulence plasmids were analyzed.</p><p><strong>Results: </strong>Virulence plasmids were present in 24.7 % of CRKP strains, with a 61.1 % mortality rate among patients with virulence plasmid-positive CRKP (pV-CRKP) infections. The ST11-KL64 subtype was predominant in Jiangxi Province. Molecular typing revealed pV-CRKP strains primarily had two identical genotypes, yet virulence plasmids were present across various PFGE genotypes, indicating polymorphic distribution. Logistic regression identified community-acquired infection, neurology department admission, and stroke as independent risk factors. G. mellonella and biofilm assays showed most CRKP strains with virulence plasmids exhibited increased virulence, though some strains did not.</p><p><strong>Conclusion: </strong>Virulence plasmids generally heighten CRKP strain virulence and directly affect the 7-day survival rate. Certain strains carry virulence plasmids without increased virulence. Community-acquired infection, neurology department admission, and stroke are independent risk factors for pV-CRKP strains. The presence of IncFrepB among pV-CRKP may promote the spread of virulence genes in ST11-type CRKP.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.jmii.2025.12.003
Farzaneh Javadimarand, Pablo Castañera, Blanca Lorente-Torres, Helena Á Ferrero, Sergio Fernández-Martínez, Jesús Llano-Verdeja, Jesús F Aparicio, Luis M Mateos, Álvaro Mourenza, Michal Letek
Background: Rhodococcus equi is a facultative intracellular pathogen that causes severe infections in foals and immunocompromised individuals. Its ability to survive within macrophages renders conventional antibiotics ineffective and promotes multidrug resistance. Novel therapeutic strategies are needed.
Methods: We screened a library of 3251 natural compounds to identify antibacterial candidates targeting R. equi. Strains included wild-type 103S+, an mrx-deficient triple mutant, and a biosensor-expressing strain carrying the Mrx1-roGFP2 probe. Minimal inhibitory concentrations, checkerboard synergy assays, and time-kill kinetics were performed. Intracellular efficacy was assessed in infected J774.A1 murine macrophages. Redox stress induction was quantified using confocal microscopy.
Results: Thirty-eight compounds selectively inhibited the mrx-deficient mutant, suggesting redox-mediated mechanisms. While most natural compound combinations showed limited intracellular activity, the pairing of erythromycin (ERY) and cinchonidine (CIN) exhibited synergy, significantly reducing intracellular bacterial load. Time-kill assays revealed bactericidal activity at 8 × MIC. Biosensor analysis confirmed that ERY-CIN synergy correlated with elevated oxidative stress, supporting a redox-based mechanism.
Conclusions: Our findings highlight CIN as a redox-active adjuvant that potentiates erythromycin's intracellular efficacy against R. equi. This combinatorial approach targets redox homeostasis and enhances bacterial clearance, providing a promising strategy against multidrug-resistant intracellular pathogens.
{"title":"Cinchonidine enhances intracellular erythromycin activity against Rhodococcus equi.","authors":"Farzaneh Javadimarand, Pablo Castañera, Blanca Lorente-Torres, Helena Á Ferrero, Sergio Fernández-Martínez, Jesús Llano-Verdeja, Jesús F Aparicio, Luis M Mateos, Álvaro Mourenza, Michal Letek","doi":"10.1016/j.jmii.2025.12.003","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.12.003","url":null,"abstract":"<p><strong>Background: </strong>Rhodococcus equi is a facultative intracellular pathogen that causes severe infections in foals and immunocompromised individuals. Its ability to survive within macrophages renders conventional antibiotics ineffective and promotes multidrug resistance. Novel therapeutic strategies are needed.</p><p><strong>Methods: </strong>We screened a library of 3251 natural compounds to identify antibacterial candidates targeting R. equi. Strains included wild-type 103S<sup>+</sup>, an mrx-deficient triple mutant, and a biosensor-expressing strain carrying the Mrx1-roGFP2 probe. Minimal inhibitory concentrations, checkerboard synergy assays, and time-kill kinetics were performed. Intracellular efficacy was assessed in infected J774.A1 murine macrophages. Redox stress induction was quantified using confocal microscopy.</p><p><strong>Results: </strong>Thirty-eight compounds selectively inhibited the mrx-deficient mutant, suggesting redox-mediated mechanisms. While most natural compound combinations showed limited intracellular activity, the pairing of erythromycin (ERY) and cinchonidine (CIN) exhibited synergy, significantly reducing intracellular bacterial load. Time-kill assays revealed bactericidal activity at 8 × MIC. Biosensor analysis confirmed that ERY-CIN synergy correlated with elevated oxidative stress, supporting a redox-based mechanism.</p><p><strong>Conclusions: </strong>Our findings highlight CIN as a redox-active adjuvant that potentiates erythromycin's intracellular efficacy against R. equi. This combinatorial approach targets redox homeostasis and enhances bacterial clearance, providing a promising strategy against multidrug-resistant intracellular pathogens.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.jmii.2025.12.002
Trinh Thi Que, Tran Van Chieu, Trieu Thuy Anh, Pham Van Ngai, Pham Van Tran, Nguyen Thai Son, Do Ngoc Anh
Background: Toxocara sp. is the most common nematode in zoonotic helminth diseases worldwide. However, data on this issue remain limited in Vietnam, particularly regarding Toxocara seroprevalence in various geographical regions.
Methods: A retrospective study was conducted on 46,284 venous blood samples from suspected toxocariasis patients across various geographical regions, which were tested at the laboratories of the Medlatec Healthcare System in Vietnam in 2023. The presence of total IgE levels and Toxocara IgG antibodies was determined using ELISA kits. Risk factors such as age, gender, geographical region, high IgE concentration (>130 IU/mL), and eosinophilia (>500 cells/μl) were evaluated.
Results: Toxocara IgG antibodies were found in 47.63 % of patients (95 % CI: 47.18-48.09). The seroprevalence of human toxocariasis was significantly different between individuals over 60 years of age and those under 60 years. The rates of IgG antibodies against Toxocara also varied significantly between different geographical regions. Accordingly, the highest seroprevalence was observed in the North Central region (59.79 %), followed by the Northern Mountainous region (51.34 %), Red River Delta (42.79 %), South West (39.91 %), South Central (36.97 %), Central Highlands (35.78 %), and South East (33.10 %), respectively. A significant association was found between eosinophilia, high IgE concentrations, and Toxocara seropositivity (p < 0.001).
Conclusion: The seropositivity rate to Toxocara spp. in different geographical regions in Vietnam in the year 2023 was relatively high. Further studies are needed to better understand the clinical relevance of these findings and to evaluate the feasibility and cost-effectiveness of targeted screening and control strategies.
{"title":"Toxocara seroprevalence among suspected patients across different geographical regions in Vietnam: A retrospective study.","authors":"Trinh Thi Que, Tran Van Chieu, Trieu Thuy Anh, Pham Van Ngai, Pham Van Tran, Nguyen Thai Son, Do Ngoc Anh","doi":"10.1016/j.jmii.2025.12.002","DOIUrl":"https://doi.org/10.1016/j.jmii.2025.12.002","url":null,"abstract":"<p><strong>Background: </strong>Toxocara sp. is the most common nematode in zoonotic helminth diseases worldwide. However, data on this issue remain limited in Vietnam, particularly regarding Toxocara seroprevalence in various geographical regions.</p><p><strong>Methods: </strong>A retrospective study was conducted on 46,284 venous blood samples from suspected toxocariasis patients across various geographical regions, which were tested at the laboratories of the Medlatec Healthcare System in Vietnam in 2023. The presence of total IgE levels and Toxocara IgG antibodies was determined using ELISA kits. Risk factors such as age, gender, geographical region, high IgE concentration (>130 IU/mL), and eosinophilia (>500 cells/μl) were evaluated.</p><p><strong>Results: </strong>Toxocara IgG antibodies were found in 47.63 % of patients (95 % CI: 47.18-48.09). The seroprevalence of human toxocariasis was significantly different between individuals over 60 years of age and those under 60 years. The rates of IgG antibodies against Toxocara also varied significantly between different geographical regions. Accordingly, the highest seroprevalence was observed in the North Central region (59.79 %), followed by the Northern Mountainous region (51.34 %), Red River Delta (42.79 %), South West (39.91 %), South Central (36.97 %), Central Highlands (35.78 %), and South East (33.10 %), respectively. A significant association was found between eosinophilia, high IgE concentrations, and Toxocara seropositivity (p < 0.001).</p><p><strong>Conclusion: </strong>The seropositivity rate to Toxocara spp. in different geographical regions in Vietnam in the year 2023 was relatively high. Further studies are needed to better understand the clinical relevance of these findings and to evaluate the feasibility and cost-effectiveness of targeted screening and control strategies.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jmii.2025.04.006
Bo-Rong Chen , Chih-Sung Lan , Ming-Luen Tsai , Hsiang-Yu Lin , Hao-Wen Cheng , Hsiao-Han Yang , Hsiao-Yu Chiu , Hung-Chih Lin , Yin-Ting Chen , Shang-Po Shen
Background
After the Coronavirus Disease 2019 (COVID-19) outbreak, there was an increasing number of febrile young infants concurrent with COVID-19. Urinary tract infection (UTI) is an important source of severe bacterial infections in febrile young infants. Accurate data on the incidence of pyuria and UTI in febrile young infants with or without COVID-19 in the post-pandemic period remains unclear.
Methods
We conducted a retrospective analysis of clinical and laboratory data from febrile young infants less than 120 days old, admitted to the Sick Baby Room of a tertiary referral hospital in Taiwan, between March 1, 2023, and February 29, 2024. These infants underwent COVID-19 testing either in the emergency department or during hospitalization.
Results
Among the 265 febrile young infants who underwent COVID-19 testing, 124 (46.8 %) tested positive. Infants with COVID-19 had a significantly lower incidence of UTI compared with those testing negative [10/124 (8.1 %) vs 47/141 (33.3 %), p < 0.001]. The incidence of sterile pyuria was relatively high in the COVID-19 positive group compared with those testing negative [45/124 (36.3 %) vs 33/141 (23.4 %), p = 0.022]. Among those with COVID-19, more patients with sterile pyuria were exposed to antibiotics than those without pyuria [12/45 (26.7 %) vs 6/69 (8.6 %), p = 0.010].
Conclusion
In febrile young infants with COVID-19, the incidence of pyuria is high, but the occurrence of definite UTI was low compared with those without COVID-19. Routine empirical antibiotic administration in febrile young infants concurrent with COVID-19 may not be necessary. These findings highlight the importance of cautious antibiotic prescribing practices in this population.
{"title":"Febrile Young Infants Less than 120 Days Old in the Post-COVID-19 Pandemic Era: Sterile Pyuria or Urinary Tract Infection?","authors":"Bo-Rong Chen , Chih-Sung Lan , Ming-Luen Tsai , Hsiang-Yu Lin , Hao-Wen Cheng , Hsiao-Han Yang , Hsiao-Yu Chiu , Hung-Chih Lin , Yin-Ting Chen , Shang-Po Shen","doi":"10.1016/j.jmii.2025.04.006","DOIUrl":"10.1016/j.jmii.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>After the Coronavirus Disease 2019 (COVID-19) outbreak, there was an increasing number of febrile young infants concurrent with COVID-19. Urinary tract infection (UTI) is an important source of severe bacterial infections in febrile young infants. Accurate data on the incidence of pyuria and UTI in febrile young infants with or without COVID-19 in the post-pandemic period remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of clinical and laboratory data from febrile young infants less than 120 days old, admitted to the Sick Baby Room of a tertiary referral hospital in Taiwan, between March 1, 2023, and February 29, 2024. These infants underwent COVID-19 testing either in the emergency department or during hospitalization.</div></div><div><h3>Results</h3><div>Among the 265 febrile young infants who underwent COVID-19 testing, 124 (46.8 %) tested positive. Infants with COVID-19 had a significantly lower incidence of UTI compared with those testing negative [10/124 (8.1 %) vs 47/141 (33.3 %), p < 0.001]. The incidence of sterile pyuria was relatively high in the COVID-19 positive group compared with those testing negative [45/124 (36.3 %) vs 33/141 (23.4 %), p = 0.022]. Among those with COVID-19, more patients with sterile pyuria were exposed to antibiotics than those without pyuria [12/45 (26.7 %) vs 6/69 (8.6 %), p = 0.010].</div></div><div><h3>Conclusion</h3><div>In febrile young infants with COVID-19, the incidence of pyuria is high, but the occurrence of definite UTI was low compared with those without COVID-19. Routine empirical antibiotic administration in febrile young infants concurrent with COVID-19 may not be necessary. These findings highlight the importance of cautious antibiotic prescribing practices in this population.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 6","pages":"Pages 695-700"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jmii.2025.05.006
Liu Chia-ying , Hsu Hsin-sui , Liao Chun-hsing
Background
Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), or long COVID, encompasses persistent symptoms following acute COVID-19, impacting quality of life. This study delineates the epidemiology, clinical presentation, and quality of life effects of long COVID in Northern Taiwan using data from the 2021 COVID-19 home quarantine telemedicine care system.
Methods
A prospective cohort of 625 PCR-confirmed COVID-19 patients, diagnosed between April and October 2021, was monitored for 3–6 months post-recovery. We assessed persistent symptoms, quality of life via the EQ-5D questionnaire, and risk factors including age, sex, vaccination status, household clusters, and hospitalization.
Results
Among participants, 22 % reported malaise, 14 % dyspnea, and 7 % cough as persistent symptoms. Older age (≥65 years) and hospitalization were associated with greater quality of life impairment across EQ-5D domains (OR = 2.72, 95 % CI: 1.60–4.63, p < 0.001). Vaccinated individuals (7 %) showed a non-significant trend toward better EQ-5D scores (p = 0.116, 95 % CI: 0.05 to 0.20).
Conclusions
Older age and hospitalization significantly predict long-term quality of life impairment in long COVID. Targeted interventions for these groups and robust post-recovery support are essential. Limitations include reliance on self-reported data, a low vaccination rate (7 %), a 3–6 months follow-up, and a single-center design, which may limit generalizability. Multi-center studies with longer follow-ups and objective biomarkers are needed to enhance further understanding.
{"title":"Long COVID Clinical Features in Northern Taiwan: Insights from a Single Medical Center Study","authors":"Liu Chia-ying , Hsu Hsin-sui , Liao Chun-hsing","doi":"10.1016/j.jmii.2025.05.006","DOIUrl":"10.1016/j.jmii.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), or long COVID, encompasses persistent symptoms following acute COVID-19, impacting quality of life. This study delineates the epidemiology, clinical presentation, and quality of life effects of long COVID in Northern Taiwan using data from the 2021 COVID-19 home quarantine telemedicine care system.</div></div><div><h3>Methods</h3><div>A prospective cohort of 625 PCR-confirmed COVID-19 patients, diagnosed between April and October 2021, was monitored for 3–6 months post-recovery. We assessed persistent symptoms, quality of life via the EQ-5D questionnaire, and risk factors including age, sex, vaccination status, household clusters, and hospitalization.</div></div><div><h3>Results</h3><div>Among participants, 22 % reported malaise, 14 % dyspnea, and 7 % cough as persistent symptoms. Older age (≥65 years) and hospitalization were associated with greater quality of life impairment across EQ-5D domains (OR = 2.72, 95 % CI: 1.60–4.63, p < 0.001). Vaccinated individuals (7 %) showed a non-significant trend toward better EQ-5D scores (p = 0.116, 95 % CI: 0.05 to 0.20).</div></div><div><h3>Conclusions</h3><div>Older age and hospitalization significantly predict long-term quality of life impairment in long COVID. Targeted interventions for these groups and robust post-recovery support are essential. Limitations include reliance on self-reported data, a low vaccination rate (7 %), a 3–6 months follow-up, and a single-center design, which may limit generalizability. Multi-center studies with longer follow-ups and objective biomarkers are needed to enhance further understanding.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 6","pages":"Pages 678-687"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The σB factor in Staphylococcus aureus governs the environmental stress response and a wide spectrum of biological functions. σB activity is regulated by protein-protein interactions among RsbU, RsbV, RsbW, and σB. While the C-terminal PP2C phosphatase domain of RsbU is well-characterized, the function of its N-terminal domain remains unclear.
Methods
To analyze the molecular weight distributions of Rsb proteins and RsbV phosphorylation states, S. aureus cell lysates were subjected to gel filtration and Phos-tag gel electrophoresis. Protein associations were investigated through coelution experiments, immunoprecipitation, and a bacterial two-hybrid assay.
Results
Gel filtration revealed a shift in RsbV phosphorylation states following stress, with unphosphorylated monomeric RsbV predominating before stress and phosphorylated RsbV increasing afterward. This shift corresponded with a decrease in RsbV's ability to sequester RsbW. Under unstressed conditions, RsbU exhibited unexpectedly high phosphatase activity; however, unphosphorylated RsbV remained inactive in sequestering RsbW. Coelution and immunoprecipitation experiments demonstrated potential associations among RsbU, RsbW, and σB. The bacterial two-hybrid assay showed direct interactions between full-length RsbU and RsbV, while RsbU interacted with RsbW only in the presence of both RsbV and σB. Further experiments identified the N-terminal domain of RsbU as mediating interactions with RsbW.
Conclusion
These findings reveal a novel σB regulatory module in S. aureus that integrates interactions among the N- and C-terminal domains of RsbU and other Rsb proteins. This module differs from σB regulatory mechanisms described in other bacteria, advancing our understanding of stress response regulation in S. aureus.
{"title":"A novel σB regulatory module in staphylococcus aureus: Unraveling the multifaceted roles of RsbU domains in stress response mechanisms","authors":"Yi-Hsi Huang , Wen-Bin Yeh , Renin Chang , Chien-Yen Chen , Michael Wing-Yan Chan , Mei-Chia Chou , Chien-Cheng Chen","doi":"10.1016/j.jmii.2025.05.007","DOIUrl":"10.1016/j.jmii.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>The σ<sup>B</sup> factor in <em>Staphylococcus aureus</em> governs the environmental stress response and a wide spectrum of biological functions. σ<sup>B</sup> activity is regulated by protein-protein interactions among RsbU, RsbV, RsbW, and σ<sup>B</sup>. While the C-terminal PP2C phosphatase domain of RsbU is well-characterized, the function of its N-terminal domain remains unclear.</div></div><div><h3>Methods</h3><div>To analyze the molecular weight distributions of Rsb proteins and RsbV phosphorylation states, <em>S. aureus</em> cell lysates were subjected to gel filtration and Phos-tag gel electrophoresis. Protein associations were investigated through coelution experiments, immunoprecipitation, and a bacterial two-hybrid assay.</div></div><div><h3>Results</h3><div>Gel filtration revealed a shift in RsbV phosphorylation states following stress, with unphosphorylated monomeric RsbV predominating before stress and phosphorylated RsbV increasing afterward. This shift corresponded with a decrease in RsbV's ability to sequester RsbW. Under unstressed conditions, RsbU exhibited unexpectedly high phosphatase activity; however, unphosphorylated RsbV remained inactive in sequestering RsbW. Coelution and immunoprecipitation experiments demonstrated potential associations among RsbU, RsbW, and σ<sup>B</sup>. The bacterial two-hybrid assay showed direct interactions between full-length RsbU and RsbV, while RsbU interacted with RsbW only in the presence of both RsbV and σ<sup>B</sup>. Further experiments identified the N-terminal domain of RsbU as mediating interactions with RsbW.</div></div><div><h3>Conclusion</h3><div>These findings reveal a novel σ<sup>B</sup> regulatory module in <em>S. aureus</em> that integrates interactions among the N- and C-terminal domains of RsbU and other Rsb proteins. This module differs from σ<sup>B</sup> regulatory mechanisms described in other bacteria, advancing our understanding of stress response regulation in <em>S. aureus</em>.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 6","pages":"Pages 652-662"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jmii.2025.06.009
Pei-Yun Kuo , Cheng-Yen Kao
Helicobacter pylori (H. pylori) is a major human pathogen, infecting nearly half of the global population. It has evolved remarkable adaptability to the harsh gastric environment, contributing to gastrointestinal diseases and gastric cancer. During infection, H. pylori encounters various environmental stresses, including acidity, reactive species, metal ion fluctuations, and osmotic changes. Two-component systems (TCSs) are key regulatory mechanisms that enable bacteria to respond to such environmental stimuli. Compared to other gram-negative bacteria, H. pylori encodes a relatively limited number of TCSs, consisting of four (ArsRS, CrdRS, FlgRS, and CheY1Y2A) along with two orphan regulators (HP1021 and HsrA). These systems regulate gene transcription, playing essential roles in bacterial adaptation and survival. Additionally, the global regulator CsrA, positioned at the center of the regulatory hierarchy, orchestrates stress response mechanisms. This review summarizes how H. pylori utilizes TCSs and CsrA to modulate cellular responses under environmental stresses. We further explore potential interactions among these regulators and discuss the feasibility of targeting TCSs and CsrA as alternative strategies for H. pylori treatment.
{"title":"Regulatory Networks in Helicobacter pylori: The Roles of Two-Component Systems and CsrA in Stress Adaptation","authors":"Pei-Yun Kuo , Cheng-Yen Kao","doi":"10.1016/j.jmii.2025.06.009","DOIUrl":"10.1016/j.jmii.2025.06.009","url":null,"abstract":"<div><div><em>Helicobacter pylori</em> (<em>H. pylori</em>) is a major human pathogen, infecting nearly half of the global population. It has evolved remarkable adaptability to the harsh gastric environment, contributing to gastrointestinal diseases and gastric cancer. During infection, <em>H. pylori</em> encounters various environmental stresses, including acidity, reactive species, metal ion fluctuations, and osmotic changes. Two-component systems (TCSs) are key regulatory mechanisms that enable bacteria to respond to such environmental stimuli. Compared to other gram-negative bacteria, <em>H. pylori</em> encodes a relatively limited number of TCSs, consisting of four (ArsRS, CrdRS, FlgRS, and CheY1Y2A) along with two orphan regulators (HP1021 and HsrA). These systems regulate gene transcription, playing essential roles in bacterial adaptation and survival. Additionally, the global regulator CsrA, positioned at the center of the regulatory hierarchy, orchestrates stress response mechanisms. This review summarizes how <em>H. pylori</em> utilizes TCSs and CsrA to modulate cellular responses under environmental stresses. We further explore potential interactions among these regulators and discuss the feasibility of targeting TCSs and CsrA as alternative strategies for <em>H. pylori</em> treatment.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 6","pages":"Pages 632-640"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jmii.2025.06.003
Andrew Po-Liang Chen , Chien-Yu Cheng , Chun-Yuan Lee , Wang-Da Liu , Mao-Wang Ho , Wei-Yen Chen , Tun-Chieh Chen , Bo-Huang Liou , Han-Chuan Chuang , Mao-Song Tsai , Meng-Yu Cheng , Hung-Jen Tang , Hung-Chin Tsai , Mei-Hui Lee , Kai-Hsiang Chen , Chen-Hsiang Lee , Chia-Wei Liu , Yi-Chien Lee , Cheng-Hsun Yang , Chia-Jui Yang
Background
By June 2024, Taiwan reported 381 Mpox virus (MPXV) cases and one death. This study aims to analyze the characteristics and clinical presentations during the first outbreak of Mpox in Taiwan.
Methods
The study was conducted across 16 hospitals and included patients aged 20 and older diagnosed with Mpox between May 2022 and March 2024. Data on demographics, symptoms, medication, vaccination history, and laboratory results were collected. Patients with HIV (PWH) were classified based on their HIV plasma viral load (PVL): undetectable viral load (UDVL) was defined as PVL<50 copies/ml, while detectable viral load (DVL) was higher. Statistical analyses examined differences among HIV-negative individuals, PWH with UDVL, and PWH with DVL, with P < .05 considered significant.
Results
A total of 178 patients were analyzed; 99.4 % were male, with 94.9 % identifying as gay, bisexual, or men who have sex with men. Two-thirds were PWH, and among them, two-thirds had UDVL. PWH with UDVL showed a lower incidence of concurrent STIs compared to those with DVL (P < .05), with syphilis being the most common STI. The vaccination rate against MPXV was about 7 %, with only nine patients vaccinated prior to acquiring the infection. Symptoms often included fever, and infections predominantly affected the genitourinary system. The number of vesicles was significantly associated with PVL (P < .05), with UDVL patients exhibiting fewer vesicles and less confluent skin lesions than those with DVL.
Conclusion
Most MPXV infections in Taiwan occur among PWH, particularly those with UDVL. Enhanced screening, vaccination efforts, and integrated STI testing are crucial in addressing this outbreak.
{"title":"Disproportionate presentation of Mpox among people with HIV: A multicenter retrospective cohort study in Taiwan","authors":"Andrew Po-Liang Chen , Chien-Yu Cheng , Chun-Yuan Lee , Wang-Da Liu , Mao-Wang Ho , Wei-Yen Chen , Tun-Chieh Chen , Bo-Huang Liou , Han-Chuan Chuang , Mao-Song Tsai , Meng-Yu Cheng , Hung-Jen Tang , Hung-Chin Tsai , Mei-Hui Lee , Kai-Hsiang Chen , Chen-Hsiang Lee , Chia-Wei Liu , Yi-Chien Lee , Cheng-Hsun Yang , Chia-Jui Yang","doi":"10.1016/j.jmii.2025.06.003","DOIUrl":"10.1016/j.jmii.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>By June 2024, Taiwan reported 381 Mpox virus (MPXV) cases and one death. This study aims to analyze the characteristics and clinical presentations during the first outbreak of Mpox in Taiwan.</div></div><div><h3>Methods</h3><div>The study was conducted across 16 hospitals and included patients aged 20 and older diagnosed with Mpox between May 2022 and March 2024. Data on demographics, symptoms, medication, vaccination history, and laboratory results were collected. Patients with HIV (PWH) were classified based on their HIV plasma viral load (PVL): undetectable viral load (UDVL) was defined as PVL<50 copies/ml, while detectable viral load (DVL) was higher. Statistical analyses examined differences among HIV-negative individuals, PWH with UDVL, and PWH with DVL, with P < .05 considered significant.</div></div><div><h3>Results</h3><div>A total of 178 patients were analyzed; 99.4 % were male, with 94.9 % identifying as gay, bisexual, or men who have sex with men. Two-thirds were PWH, and among them, two-thirds had UDVL. PWH with UDVL showed a lower incidence of concurrent STIs compared to those with DVL (P < .05), with syphilis being the most common STI. The vaccination rate against MPXV was about 7 %, with only nine patients vaccinated prior to acquiring the infection. Symptoms often included fever, and infections predominantly affected the genitourinary system. The number of vesicles was significantly associated with PVL (P < .05), with UDVL patients exhibiting fewer vesicles and less confluent skin lesions than those with DVL.</div></div><div><h3>Conclusion</h3><div>Most MPXV infections in Taiwan occur among PWH, particularly those with UDVL. Enhanced screening, vaccination efforts, and integrated STI testing are crucial in addressing this outbreak.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 6","pages":"Pages 663-669"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jmii.2025.07.013
Chou-Jui Lin , Chih-Bin Lin , Shun-Tien Chien , Yi-Wen Huang , Jen-Jyh Lee , Chih-Hsin Lee , Ming-Chih Yu , Chen-Yuan Chiang
Background
Active tuberculosis drug-safety monitoring and management (aDSM) is recommended in the treatment of rifampicin-resistant tuberculosis. We established comprehensive aDSM and conducted a nationwide multicenter prospective study in Taiwan.
Methods
We designed a treatment initiation form to capture characteristics of patients at baseline, a treatment review form to monitor symptoms, blood tests, QT intervals, and audiometry during treatment, and an adverse event report form for reporting severe adverse events (grade 3 or more), serious adverse events and adverse events resulting in discontinuation of anti-tuberculosis drugs. Severity of adverse events were categorized by using Common Terminology Criteria for Adverse Events v4.03, and causality was assessed by using the World Health Organization – Uppsala Monitoring Centre system.
Results
Of 333 patients with rifampicin-resistant tuberculosis enrolled from May 2017 to February 2020, 329 (98.8 %) had adverse events and 196 (58.9 %) had severe adverse events during treatment. The top three severe adverse events were metabolism disorders (104, 31.2 %), hearing impairment (102, 30.6 %), and hepatotoxicity (64, 19.2 %). Of 403 severe adverse events reported, 284 (70.5 %) were classified as drug-related. The top five drugs associated with severe adverse events were bedaquiline (27.6 %), clofazimine (26.7 %), kanamycin (25.1 %), pyrazinamide (22.4 %) and linezolid (22.2 %). Forty-four (13.2 %) patients were hospitalized and 15 (4.5 %) had prolonged hospitalization due to adverse events. One death was considered drug-related.
Conclusion
Severe adverse events in the treatment of rifampicin-resistant tuberculosis were more frequent than previously reported and needed to be closely monitored and timely managed by systematic and comprehensive aDSM.
{"title":"Active drug-safety monitoring and management in the treatment of rifampicin-resistant tuberculosis: a nationwide multicenter prospective study","authors":"Chou-Jui Lin , Chih-Bin Lin , Shun-Tien Chien , Yi-Wen Huang , Jen-Jyh Lee , Chih-Hsin Lee , Ming-Chih Yu , Chen-Yuan Chiang","doi":"10.1016/j.jmii.2025.07.013","DOIUrl":"10.1016/j.jmii.2025.07.013","url":null,"abstract":"<div><h3>Background</h3><div>Active tuberculosis drug-safety monitoring and management (aDSM) is recommended in the treatment of rifampicin-resistant tuberculosis. We established comprehensive aDSM and conducted a nationwide multicenter prospective study in Taiwan.</div></div><div><h3>Methods</h3><div>We designed a treatment initiation form to capture characteristics of patients at baseline, a treatment review form to monitor symptoms, blood tests, QT intervals, and audiometry during treatment, and an adverse event report form for reporting severe adverse events (grade 3 or more), serious adverse events and adverse events resulting in discontinuation of <em>anti</em>-tuberculosis drugs. Severity of adverse events were categorized by using Common Terminology Criteria for Adverse Events v4.03, and causality was assessed by using the World Health Organization – Uppsala Monitoring Centre system.</div></div><div><h3>Results</h3><div>Of 333 patients with rifampicin-resistant tuberculosis enrolled from May 2017 to February 2020, 329 (98.8 %) had adverse events and 196 (58.9 %) had severe adverse events during treatment. The top three severe adverse events were metabolism disorders (104, 31.2 %), hearing impairment (102, 30.6 %), and hepatotoxicity (64, 19.2 %). Of 403 severe adverse events reported, 284 (70.5 %) were classified as drug-related. The top five drugs associated with severe adverse events were bedaquiline (27.6 %), clofazimine (26.7 %), kanamycin (25.1 %), pyrazinamide (22.4 %) and linezolid (22.2 %). Forty-four (13.2 %) patients were hospitalized and 15 (4.5 %) had prolonged hospitalization due to adverse events. One death was considered drug-related.</div></div><div><h3>Conclusion</h3><div>Severe adverse events in the treatment of rifampicin-resistant tuberculosis were more frequent than previously reported and needed to be closely monitored and timely managed by systematic and comprehensive aDSM.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 6","pages":"Pages 735-742"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.jmii.2025.08.002
Po-Hsuan Tseng , Ling-Shan Syue , Ching‐Chi Lee , Bo-Ming Huang , Sheng-Jie Yeh , Wen-Chien Ko , Nan-Yao Lee
Background
Bloodstream infections (BSIs) are serious complications in hospitalized coronavirus disease 2019 (COVID-19) patients and may have worsened clinical outcomes. We evaluated clinical characteristics and outcomes of COVID-19 patients with BSI and compared them to a matched non-COVID-19 BSI cohort.
Methods
A retrospective cohort study was conducted at a tertiary medical center in southern Taiwan, and included adult patients hospitalized with concurrent COVID-19 and bloodstream infection (BSI) from January 2022 to April 2023. We compared survivors and non-survivors and assessed risk factors for in-hospital mortality. Propensity score matching (1:10) was used to compare COVID-19 BSI patients with non-COVID-19 BSI patients from 2017 to 2019.
Results
Among 104 COVID-19 patients with BSI, 26.0 % died during hospitalization. Male sex (adjusted OR (aOR) 5.87, 95 % confidence interval (CI) 1.51–22.83, p = 0.011), diabetes mellitus (aOR 3.89, 95 % CI 1.07–14.21, p = 0.040), Ct value ≤ 20 at diagnosis (aOR 5.15, 95 % CI 1.06–24.98, p = 0.042), Pitt bacteremia score ≥4 (aOR 5.84, 95 % CI 1.48–23.01, p = 0.012), and hospital-onset BSI (aOR 19.45, 95 % CI 3.33–113.54, p < 0.001) were independently associated with mortality. Hospital-onset BSI cases had higher rates of resistant and polymicrobial infections. Compared to non-COVID-19 BSI patients, COVID-19 BSI cases had more primary BSI and higher inappropriate empirical therapy use, though COVID-19 status itself was not independently associated with 30-day mortality after matching.
Conclusions
BSIs in COVID-19 patients are linked to high mortality, particularly in hospital-acquired infections. Timely diagnosis, risk stratification, and targeted therapy remain crucial.
{"title":"Bloodstream infections in hospitalized adults with COVID-19: clinical characteristics and outcomes","authors":"Po-Hsuan Tseng , Ling-Shan Syue , Ching‐Chi Lee , Bo-Ming Huang , Sheng-Jie Yeh , Wen-Chien Ko , Nan-Yao Lee","doi":"10.1016/j.jmii.2025.08.002","DOIUrl":"10.1016/j.jmii.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Bloodstream infections (BSIs) are serious complications in hospitalized coronavirus disease 2019 (COVID-19) patients and may have worsened clinical outcomes. We evaluated clinical characteristics and outcomes of COVID-19 patients with BSI and compared them to a matched non-COVID-19 BSI cohort.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at a tertiary medical center in southern Taiwan, and included adult patients hospitalized with concurrent COVID-19 and bloodstream infection (BSI) from January 2022 to April 2023. We compared survivors and non-survivors and assessed risk factors for in-hospital mortality. Propensity score matching (1:10) was used to compare COVID-19 BSI patients with non-COVID-19 BSI patients from 2017 to 2019.</div></div><div><h3>Results</h3><div>Among 104 COVID-19 patients with BSI, 26.0 % died during hospitalization. Male sex (adjusted OR (aOR) 5.87, 95 % confidence interval (CI) 1.51–22.83, p = 0.011), diabetes mellitus (aOR 3.89, 95 % CI 1.07–14.21, p = 0.040), Ct value ≤ 20 at diagnosis (aOR 5.15, 95 % CI 1.06–24.98, p = 0.042), Pitt bacteremia score ≥4 (aOR 5.84, 95 % CI 1.48–23.01, p = 0.012), and hospital-onset BSI (aOR 19.45, 95 % CI 3.33–113.54, p < 0.001) were independently associated with mortality. Hospital-onset BSI cases had higher rates of resistant and polymicrobial infections. Compared to non-COVID-19 BSI patients, COVID-19 BSI cases had more primary BSI and higher inappropriate empirical therapy use, though COVID-19 status itself was not independently associated with 30-day mortality after matching.</div></div><div><h3>Conclusions</h3><div>BSIs in COVID-19 patients are linked to high mortality, particularly in hospital-acquired infections. Timely diagnosis, risk stratification, and targeted therapy remain crucial.</div></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"58 6","pages":"Pages 701-707"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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