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Prospective cohort study of patient demographics, viral agents, seasonality, and outcomes of influenza-like illness in Mexico in the late H1N1-pandemic and post-pandemic years (2010-2014) 墨西哥甲型 H1N1 流感大流行后期和大流行后几年(2010-2014 年)患者人口统计学、病毒病原体、季节性和流感样病症结果的前瞻性队列研究
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-21 DOI: 10.1016/j.ijregi.2024.100394
Arturo Galindo-Fraga , Paola del Carmen Guerra-de-Blas , Ana A. Ortiz-Hernández , Kevin Rubenstein , Ana M. Ortega-Villa , Alejandra Ramírez-Venegas , Rafael Valdez-Vázquez , Sarbelio Moreno-Espinosa , Beatriz Llamosas-Gallardo , Santiago Pérez-Patrigeon , Daniel E. Noyola , Martín Magaña-Aquino , Ana Vilardell-Dávila , M. Lourdes Guerrero , John H. Powers , John Beigel , Guillermo M. Ruiz-Palacios , Mexican Emerging Infectious Disease Clinical Research Network

Objectives

Influenza-like illness (ILI) caused by respiratory viruses results in various respiratory clinical manifestations. The ILI002 prospective observational cohort study aimed to describe viral agents, seasonality, and outcomes of patients with ILI during four seasons in the influenza H1N1-pandemic and post-pandemic years (2010-2014).

Methods

Patients from six Mexican hospitals were enrolled from April 2010 to March 2014. Clinical data and nasopharyngeal swabs were obtained and tested for viral respiratory pathogens by real-time reverse-transcription polymerase chain reaction.

Results

Of the 5662 enrolled participants, 64.9% were adults and 35.1% were children. Among the 5629 participants with single-pathogen detection, rhinovirus (20.2%), influenza virus (11.2%), respiratory syncytial virus (RSV) (7.2%), and coronavirus (6.8%) were the most frequent pathogens. Co-infection occurred in 14.5% of cases; 49.3% of participants required hospitalization, particularly in RSV cases (42.9% adults, 89.6% children). The mortality rate was 2.8% higher among older adult participants and those with comorbidities. Influenza H1N1 had the highest mortality rate, yet almost half of the deceased had no pathogen. Rhinovirus persisted year-round, while influenza, coronavirus, and RSV peaked during cooler months.

Conclusions

Analyses showed that some viruses causing ILI may lead to severe disease and hospitalization irrespective of comorbidities. These findings may help in decision-making about public health policies on prevention measures, vaccination, treatment, and administration of health care.

目的由呼吸道病毒引起的流感样疾病(ILI)会导致各种呼吸道临床表现。ILI002 前瞻性观察性队列研究旨在描述甲型 H1N1 流感大流行和大流行后四个季节(2010-2014 年)中 ILI 患者的病毒病原体、季节性和预后。结果 在 5662 名登记患者中,64.9% 为成人,35.1% 为儿童。在检测到单一病原体的 5629 名参与者中,鼻病毒(20.2%)、流感病毒(11.2%)、呼吸道合胞病毒(RSV)(7.2%)和冠状病毒(6.8%)是最常见的病原体。有 14.5% 的病例合并感染;49.3% 的参与者需要住院治疗,尤其是 RSV 病例(42.9% 的成人和 89.6% 的儿童)。老年参与者和有合并症者的死亡率高出 2.8%。甲型 H1N1 流感的死亡率最高,但几乎一半的死者没有病原体。鼻病毒全年持续存在,而流感、冠状病毒和 RSV 则在较凉爽的月份达到高峰。这些发现可能有助于有关预防措施、疫苗接种、治疗和医疗管理等公共卫生政策的决策。
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引用次数: 0
Estimate the number of lives saved by a SARS-CoV-2 vaccination campaign in six states in the United States with a simple model 用简单模型估算美国六个州的 SARS-CoV-2 疫苗接种活动挽救的生命数量
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-15 DOI: 10.1016/j.ijregi.2024.100390
Yi Yin , Shuhan Tang , Qiong Li , Sijia Zhou , Yuhang Ma , Weiming Wang , Daihai He , Zhihang Peng

Objectives

Vaccination and the emergence of the highly transmissible Omicron variant changed the fate of the COVID-19 pandemic. It is very challenging to estimate the number of lives saved by vaccination given the multiple doses of vaccination, the time-varying nature of transmissibility, the waning of immunity, and the presence of immune evasion.

Methods

We established a S-SV-E-I-T-D-R model to simulate the number of lives saved by vaccination in six states in the United States (U.S.) from March 5, 2020, to March 23, 2023. The cumulative number of deaths were estimated under three vaccination scenarios based on two assumptions. Additionally, immune evasion by the Omicron and loss of protection afforded by vaccination or infection were considered.

Results

The number of deaths averted by COVID-19 vaccinations (including three doses) ranged from 0.154-0.295% of the total population across six states. The number of deaths averted by the third dose ranged from 0.008-0.017% of the total population.

Conclusions

Our estimate of death averted by COVID-19 vaccination in the U.S. was largely in line with an official estimate (at a level of 0.15-0.20% of the total population). We found that the additional contribution of the third dose was small but significant.

目标疫苗接种和高传播性 Omicron 变种的出现改变了 COVID-19 大流行的命运。考虑到疫苗接种的多剂量性、传播性的时变性、免疫力的减弱以及免疫逃避的存在,估算疫苗接种挽救的生命数量非常具有挑战性。根据两种假设,估算了三种疫苗接种情况下的累计死亡人数。结果COVID-19疫苗接种(包括三剂)避免的死亡人数占六个州总人口的0.154-0.295%。结论我们对美国因接种 COVID-19 疫苗而避免的死亡人数的估计与官方估计(占总人口的 0.15-0.20% 的水平)基本一致。我们发现,第三剂疫苗的额外贡献虽小,但意义重大。
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引用次数: 0
Predominance of Candida glabrata in candidemia among patients with solid tumor cancer in Oman: A retrospective study 阿曼实体瘤癌症患者念珠菌血症中格拉布氏念珠菌占主导地位:一项回顾性研究
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-15 DOI: 10.1016/j.ijregi.2024.100389
Bassem Awada , Aref Zribi , Ahmad Ghoche , Hasan Al-Sayegh , Manyando Milupi , Boris Itkin , Khalid Al-Baimani , Jorge Abarca

Objectives

Candida species frequently cause bloodstream infections; however, there is a lack of epidemiological studies on candidemia in Oman.

Methods

To address this, we conducted a retrospective study at Sultan Qaboos Comprehensive Cancer and Research Center from October 2021 to October 2023.

Results

Our study identified 27 episodes of candidemia among 26 patients with cancer, with an incidence of 4.9 per 1000 admissions. Non-albicans Candida (NAC) prevailed over C. albicans (70.37% vs 29.62%), with C. glabrata as the predominant NAC species (n = 10; 37%). The 30-day mortality rate was 40.7%, showing no significant difference between NAC and C. albicans but was notably higher in critically ill patients (P = 0.03).

Conclusion

In Oman, NAC surpasses C. albicans as a causative pathogen for candidemia with a high mortality rate.

方法为了解决这一问题,我们于 2021 年 10 月至 2023 年 10 月在苏丹卡布斯综合癌症研究中心进行了一项回顾性研究。结果我们的研究在 26 名癌症患者中发现了 27 例念珠菌血症,每 1000 名入院患者中的发病率为 4.9。非白念珠菌病(NAC)的发病率高于白念珠菌病(70.37% vs 29.62%),主要的NAC菌种是格拉布氏念珠菌(n = 10;37%)。30 天死亡率为 40.7%,NAC 与白念珠菌之间无显著差异,但重症患者的死亡率明显更高(P = 0.03)。
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引用次数: 0
Hospitalization for malaria in the indigenous population of Roraima, in Brazil's Northern Amazon, 2008-2022 2008-2022 年巴西北亚马逊罗赖马土著居民因疟疾住院的情况
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-14 DOI: 10.1016/j.ijregi.2024.100388
Mário Ribeiro Alves , Mary Hellem Silva Fonseca , Nilma Vitor Sant'Anna , Ricardo de Mattos Russo Rafael , Magda Guimarães de Araujo Faria , Mercedes Neto

Objectives

To examine the epidemiology of hospitalized cases of malaria in indigenous people living in the municipalities of Roraima in the northern Brazilian Amazon from 2008 to 2022.

Methods

Ecological study using secondary data and spatiotemporal analyses based on thematic maps. Average rates were calculated per study period and spatiotemporal clusters were estimated from spatial statistics.

Results

Of the 541 medical records, 77.08% were related to Plasmodium vivax. Higher rates were observed in municipalities in the south and center of the state. The rates increased throughout the study period. The analysis generated three clusters.

Conclusions

Although Roraima has characteristics that worsen the malaria problem, no studies were found that examined the transmission of the disease in the state as a whole. This increases the importance of this study, which contributes to the discussion in the field of indigenous health.

目的 研究 2008 年至 2022 年巴西亚马逊北部罗赖马市原住民疟疾住院病例的流行病学。方法 利用二手数据和基于专题地图的时空分析进行生态学研究。结果 在 541 份医疗记录中,77.08% 与间日疟原虫有关。该州南部和中部城市的发病率较高。在整个研究期间,发病率都在上升。结论虽然罗赖马的特点使疟疾问题更加严重,但没有发现任何研究对整个州的疟疾传播情况进行过调查。这增加了本研究的重要性,有助于土著健康领域的讨论。
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引用次数: 0
Human T-cell lymphotropic virus screening in France: Missed opportunities? A retrospective multicenter study of serological testing in hospital laboratories 法国的 HTLV 筛查:错失良机?医院实验室血清学检测的多中心回顾性研究
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-13 DOI: 10.1016/j.ijregi.2024.100387
Olivier Moquet , Ibrahima Faye , Nicolas Auffret , Benoit Garin , Ségolène Brichler , Raymond Césaire , French study group on HTLV testing practices

Objectives

Human T-lymphotropic virus 1 infection is endemic in the French Antilles, French Guiana, and sub-Saharan Africa, the origin of many immigrants currently living in France. There are no national screening recommendations outside of the regulatory obligations concerning donations of blood, tissue, gametes, or milk to a lactarium. This study aimed to investigate the screening and diagnostic practices for this infection in France.

Methods

Serological statistics for regulatory, antenatal, sexually transmitted infections (for CeGIDDs (Centre Gratuit d'Information, de Dépistage et de Diagnostic des Infections Sexuellement Transmissibles), which are public sexual health clinics), accidental exposure to blood screenings, and diagnosis since January 1, 2018 were collected from 23 hospital laboratories (two in the French Antilles, 21 in mainland France) associated with 55 hospitals and 22 maternity units.

Results

A total absence of antenatal screening was reported by 75% of the laboratories associated with maternity units in mainland France. All the laboratories in mainland France reported an absence of screening in the accidental exposure to blood context, as did all the laboratories in mainland France associated with a CeGIDD in the context of sexually transmitted infection screening. Conversely, screening in accordance with the existing regulations was generally systematically carried out. The most frequently reported diagnostic contexts were hematology and neurology.

Conclusions

This study reveals an underscreening of human T-lymphotropic virus 1 in the hospital laboratories of mainland France.

目标人类 T 淋巴细胞病毒 1 感染在法属安的列斯群岛、法属圭亚那和撒哈拉以南非洲地区流行,这些地区是目前居住在法国的许多移民的原籍地。除了有关向哺乳室捐献血液、组织、配子或牛奶的监管义务外,目前还没有全国性的筛查建议。本研究旨在调查法国对这种感染的筛查和诊断方法。方法从与 55 家医院和 22 家产科医院相关的 23 家医院实验室(2 家位于法属安的列斯群岛,21 家位于法国本土)收集了自 2018 年 1 月 1 日以来有关监管、产前、性传播感染(CeGIDDs(Centre Gratuit d'Information, de Dépistage et de Diagnostic des Infections Sexuellement Transmissibles),即公共性健康诊所)、意外接触血液筛查和诊断的血清学统计数据。结果75%与法国本土产科医院有关联的实验室报告完全没有进行产前筛查。法国本土的所有实验室均报告未进行意外接触血液筛查,法国本土与 CeGIDD 有关联的所有实验室也报告未进行性传播感染筛查。相反,根据现行法规进行的筛查一般都是系统性的。本研究显示,法国本土医院实验室对人类 T 淋巴细胞病毒 1 的筛查不足。
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引用次数: 0
The challenges of integrating an immigrant population with chronic hepatitis B into long-term hepatology care: Lessons learned from a Bronx West African screening program 将慢性乙型肝炎移民纳入长期肝病治疗的挑战:布朗克斯区西非筛查计划的经验教训
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-06 DOI: 10.1016/j.ijregi.2024.100385
Asli Akin Belli, Fatima Omarufilo, Jessie Birnbaum, Emmanuel U. Emeasoba, Samuel H. Sigal

Objectives

Hepatitis B virus (HBV) is endemic in West Africa. Because of immigration to the United States, screening and transition to long-term care is a significant public health concern. We describe the challenges of integrating individuals identified in a screening program into long-term care and the spectrum of disease severity.

Methods

Between 2019 and 2023, 749 individuals were screened. Beginning 2022, all were offered a free serologic evaluation. Details of the previous diagnosis, HBV care, the serologic evaluation, aspartate aminotransferase to platelet ratio index, and Fibrosis index-4 scores were recorded. The results of transient elastography (TE) were correlated with the serologic evaluation.

Results

A total of 75 (10%) individuals were hepatitis B surface antigen–positive, including 58 (77.3%) previously and 17 (22.7%) newly diagnosed. Despite attempts at linkage to care, only 14 (37.8%) of those diagnosed before the offer continued and/or entered long-term care. A total of 63 of 75 (84%) returned for the evaluation. Among 56 HBV treatment-naïve individuals, 66.1% had a serologic profile consistent with the carrier state. A total of 10 (18.2%) individuals met the criteria for HBV therapy, and 10 (21.7%) had ≥F2 fibrosis on TE. There was no correlation between aspartate aminotransferase to platelet ratio index and Fibrosis index-4 scores and TE. Eight (29.6%) of 27 patients with a profile of the HBV carrier state had ≥F2 fibrosis.

Conclusion

Integration of individuals with HBV from West Africa identified in a screening program into long-term care is challenging. Inclusion of a serologic evaluation in programs for immigrant communities should be considered. Up to 30% of individuals with a serologic profile consistent with the HBV carrier state may have ≥F2 fibrosis.

目标乙型肝炎病毒(HBV)在西非流行。由于移民到美国,筛查和过渡到长期护理是一个重要的公共卫生问题。我们描述了将筛查计划中发现的个体纳入长期护理所面临的挑战以及疾病严重程度的范围。方法在 2019 年至 2023 年期间,对 749 人进行了筛查。从 2022 年开始,所有受检者均可接受免费血清学评估。详细记录了既往诊断、HBV 护理、血清学评估、天冬氨酸氨基转移酶与血小板比值指数和纤维化指数-4 评分。结果 共有 75 人(10%)乙型肝炎表面抗原阳性,其中 58 人(77.3%)既往诊断为乙型肝炎,17 人(22.7%)新近诊断为乙型肝炎。尽管尝试了联系治疗,但在提供治疗前确诊的患者中,只有 14 人(37.8%)继续接受治疗和/或接受长期治疗。在 75 人中,共有 63 人(84%)返回接受评估。在 56 名未接受过 HBV 治疗的患者中,66.1% 的血清学特征与携带者状态相符。共有 10 人(18.2%)符合 HBV 治疗标准,10 人(21.7%)的 TE 纤维化≥F2。天冬氨酸氨基转移酶与血小板比值指数和纤维化指数-4评分与 TE 之间没有相关性。结论将筛查计划中发现的西非 HBV 感染者纳入长期护理具有挑战性。应考虑将血清学评估纳入移民社区计划。在血清学特征符合 HBV 携带状态的患者中,多达 30% 的人可能患有≥F2 纤维化。
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引用次数: 0
Association of ambient temperature with tuberculosis incidence in Japan: An ecological study 日本环境温度与肺结核发病率的关系:一项生态研究
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-04 DOI: 10.1016/j.ijregi.2024.100384
Keita Wagatsuma

Objectives

Although several studies have investigated the effects of temperature on the incidence of tuberculosis (TB) in a single city or region, few studies have investigated the variations in this association using nationwide data. This study aimed to quantify the association between temporal variations in TB incidence and temperature across Japan.

Methods

The data on the weekly number of newly confirmed TB cases and meteorological variables in 47 Japanese prefectures from 2007 to 2019 were collected. The exposure-response relationships between TB incidence and temperature were quantified using a distributed lag nonlinear model for each prefecture, and estimates from all prefectures were then pooled using a meta-regression model to derive nationwide average associations.

Results

This study included 335,060 patients with TB. Compared to those with minimum risk temperature on TB incidence (10th percentile at 4.45°C), people who were exposed to the highest temperature concentrations had a 52.0% (relative risk 1.52, 95% confidence interval 1.04-2.23) higher risk for TB incidence at the 99th percentile (30.1°C). Our results also emphasized the heterogeneity of these associations in different prefectures. Conclusions: Strengthening monitoring and public health strategies aimed at controlling temperature-related TB may be more effective when tailored to region-specific meteorological conditions.

尽管有多项研究调查了气温对单个城市或地区肺结核(TB)发病率的影响,但很少有研究使用全国范围的数据来调查这种关联的变化。本研究旨在量化日本全国肺结核发病率的时间变化与气温之间的关联。方法收集了 2007 年至 2019 年日本 47 个都道府县每周新确诊肺结核病例数和气象变量的数据。使用分布式滞后非线性模型量化了各都道府县肺结核发病率与气温之间的暴露-反应关系,然后使用元回归模型汇集所有都道府县的估计值,得出全国平均关联。与肺结核发病最低风险温度(4.45°C 时的第 10 百分位数)的人群相比,暴露于最高温度浓度的人群在第 99 百分位数(30.1°C)时的肺结核发病风险高出 52.0%(相对风险为 1.52,95% 置信区间为 1.04-2.23)。我们的研究结果还强调了这些关联在不同省份的异质性。结论加强监测和公共卫生策略以控制与气温相关的结核病,如果能针对特定地区的气象条件进行调整,可能会更加有效。
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引用次数: 0
Navigating Pakistan's immunization landscape: Progress and pitfalls 驾驭巴基斯坦的免疫格局:进展与陷阱
IF 1.5 Q4 INFECTIOUS DISEASES Pub Date : 2024-06-03 DOI: 10.1016/j.ijregi.2024.100382
Muhammad Fawad Ashraf , Safi Ur Rehman Daim , Hafsa Fayyaz , Muhammad Aizaz Ashraf , Maham Ashraf

Objectives

This study aims to assess the impact of the 2022 floods in Pakistan on the incidence of vaccine-preventable diseases (VPDs) in flood-affected regions, specifically focusing on areas with traditionally low vaccination coverage.

Design

Weekly incidence data of VPDs from September to November 2021 and 2022 were collected and analyzed for the provinces of Sindh, Khyber Pakhtunkhwa, and Baluchistan. The study compared year-on-year changes in disease incidence to evaluate the effect of the floods on disease burden.

Results

The analysis revealed significant increases in the incidence of various VPDs in the flood-affected regions compared to the previous year. Diseases such as pertussis showed a 171% increase, while mumps exhibited nearly a 1000% increase in reported cases. Other diseases including polio, diphtheria, neonatal tetanus, measles, chickenpox, and rubella also experienced substantial rises in case numbers. Concurrently, cases of lower respiratory tract illnesses and diarrheal diseases in children under five years old surged notably.

Conclusions

The findings underscored the failure of relief and healthcare efforts in managing vaccine-preventable diseases in flood-affected areas of Pakistan. The study highlights an urgent need for targeted intervention strategies, including enhanced immunization drives and healthcare infrastructure improvements in vulnerable regions. The post-flood scenario presents a critical opportunity to address existing challenges in vaccination coverage and to mitigate future disease outbreaks through comprehensive public health initiatives.

本研究旨在评估 2022 年巴基斯坦洪灾对受洪灾影响地区疫苗可预防疾病 (VPD) 发病率的影响,特别关注传统上疫苗接种覆盖率较低的地区。设计收集并分析了信德省、开伯尔-普赫图赫瓦省和俾路支省 2021 年 9 月至 11 月和 2022 年 9 月至 11 月的 VPD 每周发病率数据。研究比较了疾病发病率的同比变化,以评估洪灾对疾病负担的影响。结果分析表明,与上一年相比,受洪灾影响地区各种 VPD 的发病率显著增加。百日咳等疾病的报告病例增加了 171%,而流行性腮腺炎的报告病例增加了近 1000%。小儿麻痹症、白喉、新生儿破伤风、麻疹、水痘和风疹等其他疾病的病例数也大幅上升。与此同时,5 岁以下儿童的下呼吸道疾病和腹泻病例也显著增加。研究强调,迫切需要采取有针对性的干预战略,包括加强免疫接种活动和改善脆弱地区的医疗保健基础设施。洪灾后的形势为应对疫苗接种覆盖率方面的现有挑战以及通过全面的公共卫生举措缓解未来的疾病爆发提供了一个重要机会。
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引用次数: 0
Mycobacterium wolinskyi infection after breast augmentation: A case report and comprehensive review 隆胸术后的沃林斯基分枝杆菌感染:病例报告与综合评述
Pub Date : 2024-06-01 DOI: 10.1016/j.ijregi.2024.100378
Oscar A. Rommens , Wilfred F.A. Kolkman , Peter van Wijngaarden

We present a case report about a 26-year-old female with a Mycobacterium wolinskyi surgical site infection after bilateral breast augmentation. In a unique approach compared with previously reported cases, the patient was successfully treated in an outpatient setting using only orally administered cotrimoxazole (trimethoprim-sulfamethoxazole) and ciprofloxacin with one-sided preservation of the breast prothesis. We also provide a comprehensive overview of all report cases of M. wolinskyi infections available in the PubMed database until December 2023 and compare the different diagnostic and therapeutic approaches.

我们报告了一例 26 岁女性双侧隆胸术后手术部位感染 Wolinskyi 分枝杆菌的病例。与之前报道的病例相比,该病例采用了一种独特的方法,只需口服复方新诺明(三甲双嘧-磺胺甲噁唑)和环丙沙星,就能在门诊环境中成功治疗,并单侧保留了乳房假体。我们还全面概述了 PubMed 数据库中截至 2023 年 12 月的所有沃林斯基霉菌感染报告病例,并比较了不同的诊断和治疗方法。
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引用次数: 0
The hidden burden of melioidosis in Nepal: a paradigm for the urgent need to implement a simple laboratory algorithm to detect Burkholderia pseudomallei in low-resource endemic areas 尼泊尔的类鼻疽隐性负担:迫切需要在资源匮乏的地方病流行地区采用简单的实验室算法检测类鼻疽的范例
Pub Date : 2024-06-01 DOI: 10.1016/j.ijregi.2024.100377
Suraj Bhattarai , Isabel Klugherz , Chiranjay Mukhopadhyay , Ivo Steinmetz

Melioidosis, an emerging infectious disease caused by the Gram-negative bacillus Burkholderia pseudomallei, is massively underdiagnosed in many low- and middle-income countries. The disease is clinically extremely variable, has a high case fatality rate, and is assumed to be highly endemic in South Asian countries, including Nepal. The reasons for underdiagnosis include the lack of awareness among clinicians and laboratory staff and limited microbiological capacities. Because costly laboratory equipment and consumables are likely to remain a significant challenge in many melioidosis-endemic countries in the near future, it will be necessary to make optimum use of available tools and promote their stringent implementation. Therefore, we suggest that health facilities in resource-poor countries, such as Nepal, introduce a simple and low-cost diagnostic laboratory algorithm for the identification of B. pseudomallei cultures. This screening algorithm should be applied specifically to samples from patients with fever of unknown origin and risk factors for melioidosis, such as diabetes. In addition, there could also be a role of low-cost, novel, promising serological point-of-care tests, which are currently under research and development.

Melioidosis 是由革兰氏阴性杆菌伯克霍尔德氏假马利菌(Burkholderia pseudomallei)引起的一种新发传染病,在许多中低收入国家诊断率极低。这种疾病的临床表现极为多变,病死率很高,而且被认为在包括尼泊尔在内的南亚国家高度流行。诊断不足的原因包括临床医生和实验室工作人员缺乏认识以及微生物能力有限。由于昂贵的实验室设备和消耗品在不久的将来仍可能是许多类鼻疽流行国家面临的重大挑战,因此有必要充分利用现有工具并促进其严格执行。因此,我们建议尼泊尔等资源贫乏国家的医疗机构采用简单、低成本的实验室诊断算法来鉴定假丝酵母菌培养物。这种筛查算法应特别适用于来源不明的发热患者样本和有糖尿病等髓鞘病风险因素的患者样本。此外,目前正在研究和开发的低成本、新型、有前景的血清学床旁检测也可发挥作用。
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