BMC Infectious Diseases最新文献

Background: Non-tuberculous mycobacteria (NTM) are increasingly recognized as significant pathogens causing pulmonary and extrapulmonary diseases worldwide, including Russia. Despite a rising incidence, comprehensive data on the geographic distribution and species diversity of NTM across Russia remain limited. This study aims to analyze the prevalence and NTM species diversity in various Russian regions, highlighting regional variability and diagnostic challenges.

Methods: A systematic review and analysis of published data and regional studies on NTM detection in different regions of Russia from 2010 to 2024 were conducted. Identification methods included GenoType Mycobacterium CM/AS assays, PCR, mass spectrometry (MALDI-TOF MS) and whole-genome sequencing. Data from multiple regions, including Moscow, Saint Petersburg, the Siberian Federal District and others, were analyzed to assess species diversity and epidemiological patterns.

Results: The species spectrum of NTM in Russia is broad and heterogeneous. M. avium is the predominant species with an average frequency of 30-40%. A secondary group, including M. gordonae (13-25%) and M. intracellulare (12-20%), demonstrates significant prevalence. The remaining species, such as M. fortuitum, M. lentiflavum, M. kansasii, and M. abscessus, exhibit lower but notable frequencies ranging from 3% to 20%. Other species such as M. malmoense, M. xenopi, M. simiae etc. were less common, with frequencies below 5%. Regional differences in species prevalence were pronounced, with M. avium-intracellulare complex dominating in many areas reaching more than 50% of all NTM, while species like M. lentiflavum were more common in specific regions such as the Republic of Komi (44% of all NTM in the region). The COVID-19 pandemic (2020-2023) impacted epidemiological surveillance but did not substantially alter species diversity. Advanced molecular techniques, including whole-genome sequencing, revealed subspecies-level diversity, notably among M. avium and M. abscessus complexes.

Conclusions: This study underscores the significant geographic variability and species diversity of NTM in the Russian Federation. The detection rates and species spectrum depend on the diagnostic methods employed, highlighting the need for standardized, advanced molecular diagnostics. Continued surveillance and molecular characterization are crucial for improving diagnosis, guiding therapy, and understanding the epidemiology of NTM infections in Russia.

Background: Dengue is an increasing public health concern in Bangladesh, but its impact on health-related quality of life (HRQoL) remains poorly explored. In 2024, Bangladesh experienced a substantial rise in dengue cases. This study aimed to assess the HRQoL of hospitalized dengue patients in Bangladesh and identify its associated factors.

Methods: The cross-sectional observational study was conducted among hospitalized dengue patients in Bangladesh. HRQoL was measured using the EQ-5D-3L. Multivariable regression models examined the associations between demographic, socio-economic, and clinical factors and HRQoL outcomes (EQ-5D-3L index and EQ-VAS scores).

Results: A total of 490 hospitalized dengue patients were included, with a median age of 27 years. The majority of the patients were aged below 40 years (79%), male (80%), and residing in urban areas (73%). Group B (70%) had the highest dengue severity among participants. Most of the participants experienced problems regarding mobility (86%), self-care (80%), usual activities (85%), pain (89%), and anxiety/depression (82%). The mean EQ-5D-3L index score was 0.46 ± 0.38, and the median EQ-VAS score was 50 (IQR: 30-60). Severe dengue (Group C) was associated with the poorest HRQoL (index: 0.12 ± 0.35; VAS: 28.82 ± 16.78), compared to Group A (index: 0.62 ± 0.35; VAS: 41.02 ± 18.98; p < 0.001). Patients aged ≥60 years reported lower HRQoL (index: 0.32 ± 0.39; VAS: 35.63 ± 16.72; p < 0.001) than younger age groups. Comorbid patients had significantly reduced HRQoL (index: 0.23 ± 0.38 vs. 0.50 ± 0.36; VAS: 37.80 ± 18.22 vs. 45.72 ± 18.69; p < 0.001). Males reported higher EQ-VAS scores than females (45.65 ± 19.50 vs. 39.90 ± 14.98; p = 0.007), while urban residents had lower self-rated health than rural residents (43.44 ± 19.24 vs. 47.46 ± 17.32; p = 0.037). Multivariable regression confirmed that dengue severity, age, and comorbidities were independent predictors of both EQ-5D-3L index and EQ-VAS scores.

Conclusions: This study highlights the significant impact of dengue on HRQoL and identifies key factors associated with reduced well-being among hospitalized dengue patients in Bangladesh. These findings underscore the need for targeted interventions, particularly in vulnerable populations in resource-constrained settings, and call for further research to guide patient-centered care for this disease.

Background: Rickettsioses are an emerging public health concern in Sri Lanka, particularly in the central hills, where the Spotted Fever Rickettsiosis is prevalent. This study aimed to molecularly detect and characterize Rickettsia species in peripheral blood from patients suspected of Spotted Fever Rickettsiosis.

Methods: Peripheral blood samples were collected from 217 patients suspected of Rickettsiosis between January 2020 and June 2021. All samples were screened using the Rickettsia conorii immunoglobulin G (IgG) Indirect Immunofluorescence Antibody Test (IFAT). DNA was extracted from IFAT-positive samples and subjected to nested polymerase chain reaction (PCR) targeting the 17 kDa protein gene of Spotted Fever Rickettsiae. Selected PCR-positive samples were purified, sequenced, and analyzed using nBLAST and phylogenetic analysis.

Results: Of 217 clinically suspected patients, 137 (63.1%) had antibodies reactive with R. conorii antigen. DNA extracted from 113 seropositive blood samples underwent nested PCR targeting the 17 kDa protein gene, yielding 15 (13.2%) positives. Ten amplicons were sequenced, revealing three genotypes. Phylogenetic analysis showed one sequence with 100% identity to R. felis, marking the first molecular detection of this species in human blood in Sri Lanka. Other sequences matched multiple Spotted Fever Rickettsia species, including R. rickettsii, R. conorii, and R. parkeri, though species-level resolution was limited due to conserved gene regions. The majority of seropositive patients were middle-aged females from rural areas.

Conclusion: Findings underscore the presence of diverse, potentially virulent Rickettsia species and highlight the need for enhanced molecular surveillance. This study provides critical insights into the epidemiology of rickettsioses in Sri Lanka and supports the use of molecular tools for accurate pathogen identification, crucial for diagnosis, treatment, and vector control efforts.

Clinical trial: Not applicable.