Journal of Microbiology Immunology and Infection最新文献

Background: People with diabetes (PWD) exhibit a higher prevalence of Hepatitis C virus (HCV) infection, making them a crucial population for HCV screening and micro-elimination efforts. In light of the first published interdisciplinary consensus on managing/screening HCV in PWD, this study aims to evaluate the results and identify effective strategies for incorporating HCV screening and treatment into an existing diabetes care model managed by case managers.

Methods: This multicenter prospective program, initiated by a diabetes society, involved eighteen centers in Taiwan. Each center developed strategies to enhance HCV screening and streamline linkage to HCV care for PWD. Data on screening, diagnosis, and direct-acting antiviral (DAA) treatment were collected. Hospitals were ranked by the average number of monthly DAA treatments, and the strategies of the top five centers were compared with others.

Results: Over a median period of 6.1 months, 28,436 patients were screened, and 1379 (4.8 %) tested positive for anti-HCV antibodies (Ab). A total of 333 (24.1 %) patients were positive for HCV RNA, of whom 288 (86.4 %) received DAA treatment. Overall, 25 strategies were adopted, with the more effective being: the involvement of multidisciplinary healthcare professionals in the program, automation of information technology to search for HCV history, and patient recall for HCV Ab screening.

Conclusions: This program pioneered the evaluation of integrating of HCV screening and treatment in PWD, providing strategic insights into HCV micro-elimination through efficient patient identification and collaborative HCV management.

Community-associated methicillin-resistant Staphylococcus aureus ST8/SCCmecIVl occasionally causes invasive infections. Only severe cases harbored p32kb, with repA1, oriT-based recombination with conjugative pWtra, and a virulence gene cluster with varying citABC positivity associated with intramuscular and non-intramuscular infections. Our findings highlight the potentially critical role of citA (CitA superantigen), which may be applied as a potential severity marker.

Background: Endophthalmitis is an ophthalmic emergency. In recent years, the incidence of endogenous endophthalmitis (EE) has increased. This study aims to elucidate the clinical characteristics and risk factors associated with the visual prognosis of EE.

Methods: This study included 111 patients (121 eyes) diagnosed with EE who received intraocular and systemic treatment at Huashan Hospital, Fudan University, between January 2014 to December 2023. We conducted a comprehensive review of the demographic and clinical characteristics of the cohort and analyzed the risk factors linked to poor visual prognosis.

Results: A total of 111 patients (121 eyes) were included in this study, of whom 101 eyes (83.5 %) had identifiable pathogenic microorganisms, with Klebsiella pneumoniae (KP) was the most common pathogen. Compared to conventional culture methods (sensitivity 47.6 %), metagenomic next-generation sequencing (mNGS) demonstrated significantly higher sensitivity (97.6 %) in vitreous samples. Outcome analysis indicated that mNGS played a critical role in guiding clinical antibiotic adjustments, and patients receiving targeted therapy showed significant visual improvement (P = 0.002), with stable systemic recovery. Furthermore, vitreous surgery had a positive effect on visual prognosis (P < 0.001). Regression analysis revealed that poor initial visual acuity (VA) (OR: 20.622, 95 % CI: 3.894-109.2) and KP infection (OR: 3.398, 95 % CI: 1.096-10.538) were independent risk factors for poor final VA.

Conclusion: Our findings identify KP as the most common causative pathogen of EE. Infections caused by KP and poor initial VA are significant risk factors for poor visual outcomes. Looking ahead, mNGS holds promise as a crucial tool for the clinical diagnosis of EE.

Background: Aspergillus-specific immunoglobulin G (IgG) positivity typically indicates exposure to Aspergillus species, but its clinical significance among chronic lung diseases remains uncertain.

Methods: This prospective study enrolled patients with bronchiectasis, chronic obstructive pulmonary disease (COPD), asthma, and interstitial lung disease (ILD) in Taiwan between July 2019 and June 2023. Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were measured at baseline and repeated 1 year later. Lung function rapid decline was defined as FEV1 decline ≥ 60 mL/year or FVC decline ≥ 10 % predicted/year based on previous literature.

Results: A total of 97 patients were enrolled, including 75 (77.3 %) with bronchiectasis, 42 (43.3 %) with COPD, 26 (26.8 %) with asthma, and 6 (6.2 %) with ILD. Higher Aspergillus-specific IgG levels were significantly associated with greater FEV1 decline (r = 0.34, P < 0.001) but not with greater FVC decline (r = 0.10, P = 0.327). Multivariable analysis demonstrated that higher Aspergillus-specific IgG levels were an independent risk factor for rapid FEV1 decline (odds ratio = 1.04; 95 % confidence interval [CI]: 1.01-1.08; P = 0.007). The area under the receiver operating characteristic curve of Aspergillus-specific IgG for predicting FEV1 rapid decline was 0.72 (95 % CI: 0.61-0.82). A cutoff of 30 mgA/L provided a sensitivity of 63.64 % and specificity of 71.43 % in predicting rapid FEV1 decline.

Conclusions: Higher Aspergillus-specific IgG levels may be associated with rapid FEV1 decline in patients with chronic lung diseases, although this association requires further validation in larger, disease-specific cohorts.

Objectives: To explore factors significantly associated with plasma procalcitonin (PCT) concentration elevation among patients with monomicrobial Gram-negative bacteremia.

Methods: Sepsis patients hospitalized in intensive care units between 2020 and 2024 were eligible for this study. Their demographic characteristics, comorbidities, development of shock and disseminated intravascular coagulation, key laboratory data-including plasma C-reactive protein (CRP) and PCT concentrations-sonographic and radiographic findings, and septic workup results were collected. To determine the median PCT level, patients with monomicrobial Gram-negative bacteremia were stratified into two equal groups.

Results: Patients with bacteremia secondary to biliary tract infection (n = 24), urinary tract infection (UTI; n = 118), and primary source (n = 71), showed high proportions of Enterobacterales species as causative etiologies. A total of 358 patients with monomicrobial Gram-negative bacteremia were included in the final analysis. Patients with plasma PCT concentrations above the median value (20.2 ng/mL) did not exhibit higher mortality rates compared to those with concentrations below the median. Additionally, diabetes mellitus, UTI associated with hydronephrosis, and shock development were identified as independent predictors for markedly elevated plasma PCT concentrations among patients with monomicrobial Gram-negative bacteremia (odds ratio [OR], 1.66, 3.83, and 2.09; 95 % confidence interval [CI], 1.02-2.70, 1.64-8.93, and 1.25-3.50; P values, 0.043, 0.002, and 0.005, respectively). In contrast, the presence of Child-Pugh class C liver cirrhosis was a negative predictor of high plasma PCT concentrations (OR 0.35, 95 % CI 0.11-0.97, and P = 0.049).

Conclusions: This study recognized factors with significant impact on plasma PCT concentrations among patients with monomicrobial Gram-negative bacteremia.