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Prevalence of vaginal and cervical HPV infection among 35-year age cohort ever-married women in Kalutara district of Sri Lanka and the validity of vaginal HPV/DNA specimen as a cervical cancer screening tool: a cross-sectional study. 斯里兰卡卡卢塔拉地区 35 岁已婚妇女的阴道和宫颈 HPV 感染率以及阴道 HPV/DNA 标本作为宫颈癌筛查工具的有效性:一项横断面研究。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-05 DOI: 10.1186/s12879-024-10150-4
Kcm Perera, K N Mapitigama, Htcs Abeysena

Background: Cervical cancer is the 2nd most common female cancer among Sri Lankan females and is almost associated with sexually transmitted cervicovaginal human papillomavirus (HPV) infection. The study objectives were to determine the prevalence of vaginal and cervical HPV infection among 35year old ever-married women and assess the validity of primary healthcare provider-collected vaginal HPV/DNA specimens as a cervical cancer screening tool to improve the coverage of the programme.

Method: A descriptive cross-sectional study was carried out from the 1st of September 2018 to the 31st of January 2019. Ever-married women 35 years of age in Kalutara district were the study population. Two women from each Public Health Midwife area (n = 413) were selected randomly from the relevant area eligible families register/s. HPV/DNA cervical specimen and vaginal specimen collection (n = 621) were carried out. Specimens were screened by the Cobas 4800 HPV/DNA automated Polymerase Chain Reaction (PCR) machine. Participants' profiles were recorded by the research assistants using an interviewer-administered questionnaire.

Results: The overall prevalence of vaginal and cervical HPV infection was 7.08% (95% CI; 5.2-9.4%) and 6.12% (95% CI; 4.26-8.3%) respectively. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and the kappa coefficient of the vaginal HPV/DNA screening method vs. cervical HPV/DNA screening method were 100%, 98.9%, 86.4%, 100%, 99% and 0.92 respectively.

Conclusions: Vaginal HPV/DNA specimen screening method can be used as a cervical cancer screening tool due to its high validity. Pilots of the feasibility should be set up before the regional or national rollout of vaginal sampling strategies.

背景:宫颈癌是斯里兰卡女性第二大常见癌症,几乎与性传播的宫颈阴道人类乳头瘤病毒(HPV)感染有关。研究目标是确定 35 岁已婚妇女的阴道和宫颈 HPV 感染率,并评估初级保健提供者收集的阴道 HPV/DNA 标本作为宫颈癌筛查工具的有效性,以提高该计划的覆盖率:从 2018 年 9 月 1 日至 2019 年 1 月 31 日开展了一项描述性横断面研究。研究对象为卡卢塔拉地区 35 岁的已婚妇女。每个公共卫生助产士地区(n = 413)从相关地区合格家庭登记册中随机抽取两名妇女。进行了 HPV/DNA 宫颈标本和阴道标本采集(n = 621)。标本由 Cobas 4800 HPV/DNA 自动聚合酶链反应(PCR)机进行筛查。研究助理使用访谈者发放的调查问卷记录了参与者的情况:阴道和宫颈 HPV 感染的总体流行率分别为 7.08% (95% CI; 5.2-9.4%) 和 6.12% (95% CI; 4.26-8.3%)。阴道 HPV/DNA 筛查方法与宫颈 HPV/DNA 筛查方法的敏感性、特异性、阳性预测值 (PPV)、阴性预测值 (NPV)、诊断准确性和卡帕系数分别为 100%、98.9%、86.4%、100%、99% 和 0.92:阴道 HPV/DNA 标本筛查法的有效性较高,可用作宫颈癌筛查工具。在地区或全国范围内推广阴道采样策略之前,应先进行可行性试点。
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引用次数: 0
Long COVID and recovery from Long COVID: quality of life impairments and subjective cognitive decline at a median of 2 years after initial infection. 长期 COVID 和长期 COVID 后的恢复:初次感染后中位 2 年的生活质量损害和主观认知能力下降。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-05 DOI: 10.1186/s12879-024-10158-w
Warren Szewczyk, Annette L Fitzpatrick, Herve Fossou, Nicole L Gentile, Nona Sotoodehnia, Surabhi B Vora, T Eoin West, Jeanne Bertolli, Jennifer R Cope, Jin-Mann S Lin, Elizabeth R Unger, Quan M Vu

Background: Recovery from SARS CoV-2 infection is expected within 3 months. Long COVID occurs after SARS-CoV-2 when symptoms are present for more than 3 months that are continuous, relapsing and remitting, or progressive. Better understanding of Long COVID illness trajectories could strengthen patient care and support.

Methods: We characterized functional impairments, quality of life (QoL), and cognition among patients who recovered from SARS-CoV-2 infection within 3 months (without Long COVID), after 3 months (Recovered Long COVID), or remained symptomatic (Long COVID). Among 7305 patients identified with previous SARS-CoV-2 infection between March 2020 and December 2021, confirmed in the medical record with laboratory test or physician diagnosis, 435 (6%) completed a single self-administered survey between March 2022 and September 2022. Multi-domain QoL and cognitive concerns were evaluated using PROMIS-29 and the Cognitive Change Index-12.

Results: Nearly half the participants (47.7%) were surveyed more than 2 years from initial infection (median = 23.3 months; IQR = 18.6, 26.7) and 86.7% were surveyed more than 1 year from infection. A significantly greater proportion of the Long COVID (n = 215) group, (Current and Recovered combined), had moderate-to-severe impairment in all health domains assessed compared to those Without Long COVID (n = 220; all p < 0.05). The Recovered Long COVID group (n = 34) had significantly lower prevalence of fatigue, pain, depression, and physical and social function impairment compared to those with Current Long COVID (n = 181; all p < 0.05). However, compared to patients Without Long COVID, the Recovered Long COVID group had greater prevalences of fatigue, pain (p ≤ 0.06) and subjective cognitive decline (61.8% vs 29.1%; p < 0.01). Multivariate relative risk (RR) regression indicated Long COVID risk was greater for older age groups (RR range 1.46-1.52; all p ≤ 0.05), those without a bachelor's degree (RR = 1.33; 95% CI = 1.03-1.71; p = 0.03), and those with 3 or more comorbidities prior to SARS-CoV-2 infection (RR = 1.45; 95% CI = 1.11-1.90; p < 0.01).

Conclusions: Long COVID is associated with long-term subjective cognitive decline and diminished quality of life. Clinically significant cognitive complaints, fatigue, and pain were present even in those who reported they had recovered from Long COVID. These findings have implications for the sustainability of participation in work, education, and social activities.

背景:感染 SARS CoV-2 后预计在 3 个月内康复。在感染 SARS-CoV-2 后,如果症状持续、复发和缓解或进展超过 3 个月,就会出现长 COVID。更好地了解长COVID的发病轨迹可以加强对患者的护理和支持:我们描述了感染 SARS-CoV-2 后 3 个月内康复(无长型 COVID)、3 个月后(长型 COVID 康复)或仍有症状(长型 COVID)的患者的功能障碍、生活质量(QoL)和认知能力。在 2020 年 3 月至 2021 年 12 月期间被确认曾感染过 SARS-CoV-2 并经病历中的实验室检测或医生诊断证实的 7305 名患者中,有 435 人(6%)在 2022 年 3 月至 2022 年 9 月期间完成了一次自填式调查。采用 PROMIS-29 和认知变化指数-12 对多领域 QoL 和认知问题进行了评估:近一半的参与者(47.7%)在初次感染后 2 年以上接受了调查(中位数 = 23.3 个月;IQR = 18.6,26.7),86.7% 的参与者在感染后 1 年以上接受了调查。与无长期 COVID 患者(n=220;所有 p 均为 0)相比,长期 COVID 患者(n=215)组(当前和已康复者合计)在所有健康评估领域中具有中度至重度损伤的比例明显更高:长期 COVID 与长期主观认知能力下降和生活质量降低有关。即使是自称已从长期慢性阻塞性脑损伤中康复的患者,也会出现明显的临床认知症状、疲劳和疼痛。这些发现对能否持续参与工作、教育和社会活动具有重要意义。
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引用次数: 0
Are viral loads in the febrile phase a predictive factor of dengue disease severity? 发热期的病毒载量是登革热病情严重程度的预测因素吗?
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-05 DOI: 10.1186/s12879-024-10152-2
Shashika Dayarathna, Heshan Kuruppu, Tehani Silva, Laksiri Gomes, N L Ajantha Shyamali, Chandima Jeewandara, Dinuka Ariyaratne, Shyrar Tanussiya Ramu, Ananda Wijewickrama, Graham S Ogg, Gathsaurie Neelika Malavige

Background: As many studies have shown conflicting results regarding the extent of viraemia and clinical disease severity, we sought to investigate if viraemia during early dengue illness is associated with subsequent clinical disease severity.

Methods: Realtime PCR was carried out to identify the dengue virus (DENV serotype), in 362 patients, presenting within the first 4 days of illness, from 2017 to 2022, in Colombo Sri Lanka. To characterize subsequent clinical disease severity, all patients were followed throughout their illness daily and disease severity classified according to WHO 1997 and 2009 disease classification.

Results: 263 patients had DF, 99 progressed to develop DHF, and 15/99 with DHF developed shock (DSS). Although the viral loads were higher in the febrile phase in patients who progressed to develop DHF than in patients with DF this was not significant (p = 0.5). Significant differences were observed in viral loads in patients infected with different DENV serotypes (p = 0.0009), with lowest viral loads detected in DENV2 and the highest viral loads in DENV3. Sub-analysis for association of viraemia with disease severity for each DENV serotype was again not significant. Although those infected with DENV2 had lower viral loads, infection with DENV2 was significantly associated with a higher risk of developing DHF (p = 0.011, Odds ratio 1.9; 95% CI 1.164 to 3.078). Based on the WHO 2009 disease classification, 233 had dengue with warning signs (DWW), 114 dengue without warning signs (DWoWS), and 15 had severe dengue (SD). No significant difference was observed in the viral loads between those with SD, DWW and DWoWS (p = 0.27).

Conclusions: Viral loads were significantly different in the febrile phase between different DENV serotypes, and do not appear to significantly associate with subsequent clinical disease severity in a large Sri Lankan cohort.

背景:关于登革热病毒血症和临床疾病严重程度的许多研究结果相互矛盾:由于许多研究在病毒血症程度和临床疾病严重程度方面显示出相互矛盾的结果,我们试图调查登革热早期发病期间的病毒血症是否与随后的临床疾病严重程度有关:方法:2017 年至 2022 年,我们对斯里兰卡科伦坡 362 名发病 4 天内的患者进行了实时 PCR 检测,以确定登革热病毒(DENV 血清型)。为了描述随后的临床疾病严重程度,对所有患者进行了每日全程随访,并根据世界卫生组织1997年和2009年疾病分类对疾病严重程度进行了分类。结果:263名患者患有登革热,99名进展为登革热性休克,15/99名登革热性休克患者出现休克(DSS)。虽然进展为 DHF 的患者发热期的病毒载量高于 DF 患者,但差异并不显著(p = 0.5)。在感染不同DENV血清型的患者中,病毒载量存在显著差异(p = 0.0009),DENV2的病毒载量最低,而DENV3的病毒载量最高。对每种 DENV 血清型的病毒血症与疾病严重程度的相关性进行的子分析结果也不显著。虽然DENV2感染者的病毒载量较低,但DENV2感染者罹患DHF的风险明显较高(p = 0.011,Odds ratio 1.9; 95% CI 1.164 to 3.078)。根据世界卫生组织 2009 年的疾病分类,233 例登革热患者有警示症状(DWW),114 例登革热患者无警示症状(DWoWS),15 例登革热患者病情严重(SD)。SD、DWW 和 DWoWS 患者的病毒载量无明显差异(p = 0.27):结论:在一个大型斯里兰卡队列中,不同血清型的登革热病毒在发热期的病毒载量有明显差异,但似乎与随后的临床疾病严重程度没有明显关联。
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引用次数: 0
Correction: Meningitis after COVID-19 vaccination, a systematic review of case reports and case series. 更正:接种 COVID-19 疫苗后发生脑膜炎,病例报告和系列病例的系统回顾。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-05 DOI: 10.1186/s12879-024-10087-8
Amirhomayoun Atefi, Aref Ghanaatpisheh, Amirhosein Ghasemi, Hoda Haghshenas, Kimia Eyvani, Arash Bakhshi, Mohammad Ali Esfandiari, Cena Aram, Alia Saberi
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引用次数: 0
Clinical manifestations and treatment of candidemia caused by different Candida species: a retrospective study. 由不同念珠菌引起的念珠菌血症的临床表现和治疗:一项回顾性研究。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-04 DOI: 10.1186/s12879-024-10128-2
Chenguang Zhang, Sheng Wu, Xuyan Chen, Hao Yang, Wenshi Feng, Tao Yuan, Yiming Wang

Objective: Candidemia leads to higher mortality and longer hospital-stay. While the studies about the clinical manifestations of candidemia caused by different Candida species and the relationship between the antifungal drugs and prognosis were rarely performed.

Methods: This retrospective study enrolled all 94 patients diagnosed as candidemia from January 2020 to July 2023 in BTCH. Demographic information, comorbidities, laboratory parameters, medications and prognosis were collected and analyzed.

Results: C. albicans was the most common specie of candidemia. There was no significant difference in age, gender and hospital-mortality in different species groups. Higher-level and longer duration of broad-spectrum antibiotic use, lower BMI, hypoalbuminemia, longer duration of PN and history of G+ coccemia were conclusive about mortality. The C.tropicalis group had higher SCRE levels (F = 8.40, P = 0.03) and shorter TTP (F = 5.03, P < 0.01) than other species. No distinction was found in different antifungal drugs groups including triazoles and echinocandins after 7 days treatment (χ2 = 0.05, P = 0.81). The efficacy was no difference between triazoles and echinocandins in the different species groups. (χ12 = 1.20, P1 = 0.75; χ22 = 0.05, P2 = 0.81).

Conclusion: C. albicans accounts the most among candida induecd candidemia.The C.tropicalis group had higher SCRE levels and shorter TTP than other groups. Elder, hypoproteinemia, lower BMI, longer duration and higher-level of broad-spectrum antibiotic use, longer PN support and G+ coccemia increase risks for candidemia. The efficacy of triazoles and echinocandins are the same when blood culture turned negative in 7 days.

目的:念珠菌病会导致更高的死亡率和更长的住院时间。而关于不同念珠菌引起的念珠菌血症的临床表现以及抗真菌药物与预后之间关系的研究却很少:这项回顾性研究纳入了北京天坛医院 2020 年 1 月至 2023 年 7 月期间诊断为念珠菌血症的所有 94 例患者。收集并分析了人口统计学信息、合并症、实验室指标、药物和预后:结果:白念珠菌是念珠菌病最常见的菌种。不同种类的患者在年龄、性别和住院死亡率方面没有明显差异。广谱抗生素使用水平较高且持续时间较长、体重指数较低、低白蛋白血症、PN持续时间较长以及G+球菌血症病史对死亡率有决定性影响。热带杆菌组的 SCRE 水平更高(F = 8.40,P = 0.03),TTP 更短(F = 5.03,P 2 = 0.05,P = 0.81)。在不同物种组中,三唑类和棘白菌素类的疗效没有差异。(χ12=1.20,P1=0.75;χ22=0.05,P2=0.81):热带念珠菌组的 SCRE 水平较高,TTP 较其他组短。老年人、低蛋白血症、体重指数较低、广谱抗生素使用时间较长、水平较高、PN支持时间较长以及G+球菌血症会增加念珠菌血症的风险。当血液培养在 7 天内转为阴性时,三唑类和棘白菌素类的疗效相同。
{"title":"Clinical manifestations and treatment of candidemia caused by different Candida species: a retrospective study.","authors":"Chenguang Zhang, Sheng Wu, Xuyan Chen, Hao Yang, Wenshi Feng, Tao Yuan, Yiming Wang","doi":"10.1186/s12879-024-10128-2","DOIUrl":"10.1186/s12879-024-10128-2","url":null,"abstract":"<p><strong>Objective: </strong>Candidemia leads to higher mortality and longer hospital-stay. While the studies about the clinical manifestations of candidemia caused by different Candida species and the relationship between the antifungal drugs and prognosis were rarely performed.</p><p><strong>Methods: </strong>This retrospective study enrolled all 94 patients diagnosed as candidemia from January 2020 to July 2023 in BTCH. Demographic information, comorbidities, laboratory parameters, medications and prognosis were collected and analyzed.</p><p><strong>Results: </strong>C. albicans was the most common specie of candidemia. There was no significant difference in age, gender and hospital-mortality in different species groups. Higher-level and longer duration of broad-spectrum antibiotic use, lower BMI, hypoalbuminemia, longer duration of PN and history of G<sup>+</sup> coccemia were conclusive about mortality. The C.tropicalis group had higher SCRE levels (F = 8.40, P = 0.03) and shorter TTP (F = 5.03, P < 0.01) than other species. No distinction was found in different antifungal drugs groups including triazoles and echinocandins after 7 days treatment (χ<sup>2</sup> = 0.05, P = 0.81). The efficacy was no difference between triazoles and echinocandins in the different species groups. (χ<sub>1</sub><sup>2</sup> = 1.20, P<sub>1</sub> = 0.75; χ<sub>2</sub><sup>2</sup> = 0.05, P<sub>2</sub> = 0.81).</p><p><strong>Conclusion: </strong>C. albicans accounts the most among candida induecd candidemia.The C.tropicalis group had higher SCRE levels and shorter TTP than other groups. Elder, hypoproteinemia, lower BMI, longer duration and higher-level of broad-spectrum antibiotic use, longer PN support and G<sup>+</sup> coccemia increase risks for candidemia. The efficacy of triazoles and echinocandins are the same when blood culture turned negative in 7 days.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11533373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
GATA2 deficiency and hemophagocytic lymphohistiocytosis (HLH): a systematic review of reported cases. GATA2 缺乏症与嗜血细胞淋巴组织细胞增多症(HLH):对已报道病例的系统回顾。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-04 DOI: 10.1186/s12879-024-10145-1
Mohammad Rezaei Zadeh Rukerd, Hanieh Mirkamali, Mohsen Nakhaie, Seyed Danial Alizadeh

Purpose: GATA2 deficiency is an autosomal dominant disease that manifests with a range of clinical symptoms, including increased susceptibility to viral, bacterial, and fungal infections. Furthermore, the increased susceptibility to infections in GATA2 deficiency can trigger hemophagocytic lymphohistiocytosis (HLH) in these patients. Our systematic review evaluates reported cases of GATA2 deficiency and HLH in the literature.

Methods: A systematic review of case reports was conducted following PRISMA 2020 guidelines, encompassing studies retrieved from Ovid MEDLINE ALL, Embase via Ovid SP, Scopus, Web of Science, and Google Scholar from inception until June 14, 2024. This review included studies reporting patients diagnosed with GATA2 deficiency or having a documented history of the condition, who subsequently developed or were concurrently diagnosed with HLH. Various study types were considered, such as case reports, case series, letters to editors, original articles, correspondences, and commentaries, without any restrictions on language.

Results: In our systematic review, 15 studies from 2016 to 2024 were analyzed, encompassing 23 patients with GATA2 deficiency and HLH. the mean (SD) age of patients was 23.48 (10.54) years, ranging from 7 to 57 years. These patients exhibited diverse genetic mutations and a spectrum of infections, particularly Mycobacterium avium (M. avium), Mycobacterium kansasii (M. kansasii), Epstein-Barr virus (EBV), cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), and influenza A, often leading to HLH. Family histories of GATA2-deficient patients with HLH occasionally reveal confirmed GATA2 mutations or suspicious cases among first-degree relatives. Hematopoietic stem cell transplantation (HSCT) was performed in 8 patients with GATA2 deficiency and HLH. Among them, 6 patients survived post-therapy, while 2 patients died following HSCT. Currently, 1 patient is being considered for HSCT. The overall mortality rate among GATA2 deficiency patients who experienced HLH was 39.13%.

Conclusions: This systematic review highlights GATA2 deficiency's association with diverse infections triggering HLH, emphasizing early infection management to mitigate mortality risks. This comprehensive analysis contributes to scientific knowledge, offering important insights for clinicians and researchers in diagnosing and managing this rare condition.

目的:GATA2 缺乏症是一种常染色体显性遗传病,表现为一系列临床症状,包括对病毒、细菌和真菌感染的易感性增加。此外,GATA2 缺乏症患者对感染的易感性增加可能引发嗜血细胞淋巴组织细胞增多症(HLH)。我们的系统综述评估了文献中报道的 GATA2 缺乏症和 HLH 病例:我们按照 PRISMA 2020 指南对病例报告进行了系统综述,包括从 Ovid MEDLINE ALL、Embase via Ovid SP、Scopus、Web of Science 和 Google Scholar 检索到的从开始到 2024 年 6 月 14 日的研究。本综述包括报告被诊断为 GATA2 缺乏症或有病史记录的患者随后发展为或同时被诊断为 HLH 的研究。我们考虑了各种研究类型,如病例报告、系列病例、致编辑的信、原创文章、通信和评论,对语言没有任何限制:在我们的系统性综述中,分析了2016年至2024年的15项研究,其中包括23例GATA2缺乏症和HLH患者。这些患者表现出多种基因突变和一系列感染,尤其是禽分枝杆菌(M. avium)、堪萨斯分枝杆菌(M. kansasii)、Epstein-Barr病毒(EBV)、巨细胞病毒(CMV)、水痘-带状疱疹病毒(VZV)、单纯疱疹病毒(HSV)和甲型流感,通常会导致HLH。GATA2缺陷型HLH患者的家族病史中偶尔会发现确诊的GATA2突变或一级亲属中的可疑病例。有8名GATA2缺乏症合并HLH的患者接受了造血干细胞移植(HSCT)。其中,6 名患者在治疗后存活,2 名患者在造血干细胞移植后死亡。目前,1名患者正在考虑进行造血干细胞移植。GATA2缺乏症合并HLH患者的总死亡率为39.13%:本系统综述强调了 GATA2 缺乏症与引发 HLH 的各种感染之间的关联,并强调了早期感染管理以降低死亡风险。这项全面的分析为科学知识做出了贡献,为临床医生和研究人员诊断和管理这种罕见疾病提供了重要的启示。
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引用次数: 0
Immunopathological markers and cell types linked to COVID-19 symptom manifestation. 与 COVID-19 症状表现相关的免疫病理标记物和细胞类型。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-04 DOI: 10.1186/s12879-024-10139-z
Ha Won Song, Hye-Yeong Jo, Sang Cheol Kim, Sun Shim Choi

Background: Numerous studies have investigated the molecular properties that contribute to the symptoms of COVID-19, such as the virus's genetic makeup, its replication mechanisms, and how it interacts with host cells. However, identifying the immunopathological properties, such as the immune system's response, cytokine levels, and the presence of specific biomarkers, that are associated with the severity of the infection remains crucial for developing effective treatments and preventions.

Methods: We analyzed blood protein factor profiles from 420 individuals to identify features differentiating between test-negative healthy, asymptomatic, and symptomatic individuals using statistical comparison and the least absolute shrinkage and selection operator (i.e., LASSO) algorithm. Additionally, we examined single-cell RNA sequencing data from 141 individuals to identify specific cell types associated with the COVID-19 symptoms.

Results: Healthy individuals who tested negative had distinct blood protein factor levels compared to asymptomatic individuals. We identified two key protein factors, Serpin A10 and Complement C9, that differentiate between asymptomatic and symptomatic patients. Symptomatic patients showed lower levels of CD4+ T naïve, CD4+ T effector & memory, and CD8+ T naïve cells, along with higher levels of CD14+ classical monocytes compared to asymptomatic patients. Additionally, CD16+ non-classical monocytes, major producers of C1QA/B/C, appeared to contribute to the observed Complement C9 levels.

Conclusions: These findings advance our understanding of the immunopathological mechanisms underlying COVID-19 and may inform the development of targeted therapies and preventative measures. Future research should focus on further elucidating these mechanisms and exploring their potential clinical applications in managing COVID-19 severity.

背景:许多研究都对导致 COVID-19 症状的分子特性进行了调查,如病毒的基因构成、复制机制以及如何与宿主细胞相互作用。然而,确定与感染严重程度相关的免疫病理特性,如免疫系统的反应、细胞因子水平和特定生物标志物的存在,对于开发有效的治疗和预防方法仍然至关重要:我们分析了 420 人的血液蛋白因子图谱,利用统计比较和最小绝对收缩和选择算子(即 LASSO)算法确定了区分检测阴性的健康人、无症状者和有症状者的特征。此外,我们还研究了 141 人的单细胞 RNA 测序数据,以确定与 COVID-19 症状相关的特定细胞类型:结果:与无症状的个体相比,检测结果呈阴性的健康个体具有不同的血液蛋白因子水平。我们确定了两个关键的蛋白因子,即 Serpin A10 和补体 C9,它们可区分无症状和有症状的患者。与无症状患者相比,有症状患者的 CD4+ T 幼稚细胞、CD4+ T 效应和记忆细胞、CD8+ T 幼稚细胞水平较低,CD14+ 经典单核细胞水平较高。此外,CD16+非典型单核细胞是C1QA/B/C的主要产生者,它们似乎对观察到的补体C9水平有所贡献:这些发现加深了我们对 COVID-19 背后的免疫病理机制的理解,可为开发靶向疗法和预防措施提供依据。未来的研究应侧重于进一步阐明这些机制,并探索其在控制 COVID-19 严重程度方面的潜在临床应用。
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引用次数: 0
Streptococcus salivarius pneumonia-associated pneumomediastinum: a case report and literature review. 唾液链球菌肺炎相关性气胸:病例报告和文献综述。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-04 DOI: 10.1186/s12879-024-10138-0
Zhuo Chen, Keheng Xiang, Kaijin Wang, Bicui Liu

Background: Streptococcus salivarius is an opportunistic pathogen, and there have been no reported cases of Streptococcus salivarius pneumonia to date. Pneumomediastinum is usually secondary to tracheal or esophageal injury and is very rare as a complication of pneumonia. We report a case of Streptococcus salivarius pneumonia complicated by pneumomediastinum, aiming to enhance clinicians' awareness of rare pathogens and uncommon complications in pneumonia.

Case presentation: The patient, a 36-year-old male, presented with a persistent cough and sputum production for one week, accompanied by a sore throat that had developed just one day prior. Chest computed tomography (CT) disclosed pneumomediastinum alongside obstructive atelectasis in the left lower lobe. Streptococcus salivarius infection was conclusively identified through bronchoalveolar lavage metagenomic next-generation sequencing (mNGS), as well as smear and culture analyses. The patient was administered intravenous amoxicillin-clavulanate potassium for a duration of seven days as part of the anti-infection regimen. Given the stability of the patient's respiratory and circulatory systems, a tube drainage procedure was deemed unnecessary. Post-treatment, the patient's clinical symptoms notably improved. A subsequent chest CT scan revealed the re-expansion of the left lower lung and near-complete resolution of pneumomediastinum.

Conclusion: There are numerous pathogens that can cause pneumonia. While focusing on common pathogens, it is important not to overlook rare ones. When considering infections from rare pathogens, it is recommended to promptly perform a bronchoscopy and submit bronchoalveolar lavage fluid for mNGS to improve pathogen detection rates. During the diagnosis and treatment of pneumonia, it is crucial to be vigilant for rare complications. When a patient presents with symptoms such as dyspnea or subcutaneous emphysema, it is advisable to immediately perform a chest CT scan to rule out pneumomediastinum.

背景:唾液链球菌是一种机会性病原体,迄今为止尚未有唾液链球菌肺炎病例的报道。气胸通常继发于气管或食管损伤,作为肺炎的并发症非常罕见。我们报告了一例唾液链球菌肺炎并发气胸的病例,旨在提高临床医生对罕见病原体和肺炎罕见并发症的认识:患者是一名 36 岁的男性,因持续咳嗽、咳痰一周,并伴有前一天才出现的咽喉痛而就诊。胸部计算机断层扫描(CT)显示,左下叶存在气胸和阻塞性肺不张。通过支气管肺泡灌洗液元基因组新一代测序(mNGS)以及涂片和培养分析,最终确定了唾液链球菌感染。作为抗感染治疗方案的一部分,患者接受了为期七天的阿莫西林-克拉维酸钾静脉注射。鉴于患者的呼吸和循环系统稳定,没有必要进行插管引流手术。治疗后,患者的临床症状明显好转。随后的胸部 CT 扫描显示,左下肺再次扩张,气胸几乎完全消退:结论:引起肺炎的病原体有很多。在关注常见病原体的同时,也不能忽视罕见病原体。在考虑罕见病原体感染时,建议及时进行支气管镜检查,并将支气管肺泡灌洗液送检 mNGS,以提高病原体的检出率。在肺炎的诊断和治疗过程中,警惕罕见并发症至关重要。当患者出现呼吸困难或皮下气肿等症状时,建议立即进行胸部 CT 扫描以排除气胸。
{"title":"Streptococcus salivarius pneumonia-associated pneumomediastinum: a case report and literature review.","authors":"Zhuo Chen, Keheng Xiang, Kaijin Wang, Bicui Liu","doi":"10.1186/s12879-024-10138-0","DOIUrl":"10.1186/s12879-024-10138-0","url":null,"abstract":"<p><strong>Background: </strong>Streptococcus salivarius is an opportunistic pathogen, and there have been no reported cases of Streptococcus salivarius pneumonia to date. Pneumomediastinum is usually secondary to tracheal or esophageal injury and is very rare as a complication of pneumonia. We report a case of Streptococcus salivarius pneumonia complicated by pneumomediastinum, aiming to enhance clinicians' awareness of rare pathogens and uncommon complications in pneumonia.</p><p><strong>Case presentation: </strong>The patient, a 36-year-old male, presented with a persistent cough and sputum production for one week, accompanied by a sore throat that had developed just one day prior. Chest computed tomography (CT) disclosed pneumomediastinum alongside obstructive atelectasis in the left lower lobe. Streptococcus salivarius infection was conclusively identified through bronchoalveolar lavage metagenomic next-generation sequencing (mNGS), as well as smear and culture analyses. The patient was administered intravenous amoxicillin-clavulanate potassium for a duration of seven days as part of the anti-infection regimen. Given the stability of the patient's respiratory and circulatory systems, a tube drainage procedure was deemed unnecessary. Post-treatment, the patient's clinical symptoms notably improved. A subsequent chest CT scan revealed the re-expansion of the left lower lung and near-complete resolution of pneumomediastinum.</p><p><strong>Conclusion: </strong>There are numerous pathogens that can cause pneumonia. While focusing on common pathogens, it is important not to overlook rare ones. When considering infections from rare pathogens, it is recommended to promptly perform a bronchoscopy and submit bronchoalveolar lavage fluid for mNGS to improve pathogen detection rates. During the diagnosis and treatment of pneumonia, it is crucial to be vigilant for rare complications. When a patient presents with symptoms such as dyspnea or subcutaneous emphysema, it is advisable to immediately perform a chest CT scan to rule out pneumomediastinum.</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High-density lipoprotein cholesterol and nasal colonization of Staphylococcus aureus: results from the 2001-2004 National Health and Nutrition Examination Survey (NHANES). 高密度脂蛋白胆固醇与金黄色葡萄球菌的鼻腔定植:2001-2004 年全国健康与营养调查 (NHANES) 的结果。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-04 DOI: 10.1186/s12879-024-10125-5
Jingli Wen, Zhenjiang Zhang

Background: High-density lipoprotein cholesterol (HDL-C) is negatively associated with infectious diseases, but the relationship between HDL-C and nasal colonization of Staphylococcus aureus is unclear.

Objective: To investigate the relationship between HDL-C and nasal colonization of Staphylococcus aureus.

Methods: The cross-sectional study included 7731 participants from the 2001-2004 National Health and Nutrition Inspection Survey (NHANES) survey cycle who had complete data. After adjusting demographics and lifestyle, we used multivariate logistic regression to analyze the relationship between HDL-C and nasal colonization of Staphylococcus aureus. We also used restricted cubic splines (RCS) to analyze the nonlinear relationship between HDL-C and nasal colonization of Staphylococcus aureus. All the analyses adjusted the relevant covariates.

Results: The mean of HDL-C in this study was 1.38 ± 0.64 mmol/L and the colonization rate of nasal colonization of Staphylococcus aureus was 26.2%. Both unadjusted model (OR = 0.71; 95%CI: 0.62-0.80; P < 0.001) and preliminary adjusted model (model 1: OR = 0.77; 95%CI: 0.67-0.89; P < 0.001) showed a significant negative correlation between HDL-C and nasal colonization of Staphylococcus aureus. After adjusting all variables in model 3, the relationship between HDL-C and nasal colonization of Staphylococcus aureus was still significant and negatively correlated (OR = 0.79; 95%CI: 0.69-0.92; P = 0.002). In addition, through RCS analysis, there was also a significant negative correlation between HDL-C and nasal colonization of Staphylococcus aureus (P for non-linear = 0.034). In subgroup analysis, only gender has a significant impact on this relationship (P for interaction = 0.013). In male, for each additional raising unit of HDL-C, the risk of nasal colonization of Staphylococcus aureus decreased by 38% (OR = 0.62, 95%CI: 0.49-0.79); in female, the relationship was no longer significant. We did not observe the interaction between all the other subgroup analysis results (P for interaction > 0.05).

Conclusions: We found that HDL-C was negatively correlated with nasal colonization of Staphylococcus aureus, especially in male, even after adjusting for various variables. These findings provide valuable insights into the development of early intervention strategies in people at high risk of infectious diseases.

背景:高密度脂蛋白胆固醇(HDL-C高密度脂蛋白胆固醇(HDL-C)与传染病呈负相关,但HDL-C与金黄色葡萄球菌鼻腔定植之间的关系尚不清楚:研究 HDL-C 与金黄色葡萄球菌鼻腔定植之间的关系:这项横断面研究纳入了 7731 名来自 2001-2004 年国家健康与营养检测调查(NHANES)调查周期、拥有完整数据的参与者。在对人口统计学和生活方式进行调整后,我们使用多变量逻辑回归分析了高密度脂蛋白胆固醇与金黄色葡萄球菌鼻腔定植之间的关系。我们还使用了限制性立方样条(RCS)来分析 HDL-C 与金黄色葡萄球菌鼻腔定植之间的非线性关系。所有分析都对相关协变量进行了调整:本研究中 HDL-C 的平均值为 1.38 ± 0.64 mmol/L,金黄色葡萄球菌的鼻腔定植率为 26.2%。两者的未调整模型(OR = 0.71; 95%CI: 0.62-0.80; P 0.05):我们发现,即使调整了各种变量,高密度脂蛋白胆固醇与金黄色葡萄球菌的鼻腔定植仍呈负相关,男性尤其如此。这些发现为制定传染病高危人群的早期干预策略提供了有价值的见解。
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引用次数: 0
Probiotic-based therapy as a new useful strategy for the treatment of patients with traumatic brain injury. 基于益生菌的疗法是治疗脑外伤患者的有效新策略。
IF 3.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2024-11-04 DOI: 10.1186/s12879-024-10146-0
Hanieh Asaadi, Abdolreza Narouiepour, Arezo Haji, Masoud Keikha, Mohsen Karbalaei

Background: In the new era, microbial-based medicine is one of the best strategies that try to modify the normal flora with the aim of treating some disorders. This systematic review and meta-analysis was performed to evaluate the use of probiotics in the treatment of the clinical outcomes in cases with traumatic brain injury..

Methods: In this regard, the search strategy was done using databases such as PubMed, Embase, Scopus, CENTRAL, and Google Scholar, from 2006 until April 2024. All studies about the efficacy of probiotic supplementation on the clinical outcomes in traumatic brain injury patients were retrieved. During the assessment process of the eligible studies, we evaluated clinical characteristics such as the Glasgow Coma Scale score, the Sequential Organ Failure Assessment score, the Acute Physiology and Chronic Health Evaluation II score, referral rate and hospitalization period in the intensive care unit, mortality rate, as well as opportunistic infections in both groups of case and control..

Results: In this study, the authors analyzed data from 6 articles including 391 cases with traumatic brain injury. Our results showed that the probiotic therapy increases the Glasgow Coma Scale score in patients with the average age of more than 50 years. However, there was no a significant difference in the Sequential Organ Failure Assessment and the Acute Physiology and Chronic Health Evaluation scores between the group that had received probiotics and the control group. Although probiotic-based treatment did not significantly affect the intensive care unit admission (or length of stay), but, the risk of infection, and also mortality was significantly lower in the probiotic group (OR: 0.53; 95% CI: 0.3 to 0.8, as well as OR: 0.41; 95% CI: 0.2 to 0.7, respectively)..

Conclusions: Overall, due to the modification of microbial flora, probiotic supplements can balance microflora disturbances, which in turn leads to improvement the clinical outcomes in patients with brain injury. Therefore, probiotic-based therapy can be considered as a promising strategy for the treatment of the central nervous system disorders. However, given the limited evidence, more clinical trial studies need to strengthen our results..

背景:在新时代,以微生物为基础的医学是试图改变正常菌群以治疗某些疾病的最佳策略之一。本系统综述和荟萃分析旨在评估使用益生菌治疗脑外伤病例的临床效果:为此,研究人员利用 PubMed、Embase、Scopus、CENTRAL 和 Google Scholar 等数据库,对 2006 年至 2024 年 4 月期间的研究进行了检索。检索了所有关于补充益生菌对脑外伤患者临床疗效的研究。在对符合条件的研究进行评估的过程中,我们对病例组和对照组的临床特征进行了评估,如格拉斯哥昏迷量表评分、器官功能衰竭顺序评估评分、急性生理学和慢性健康评估 II 评分、转诊率和重症监护室住院时间、死亡率以及机会性感染等:在这项研究中,作者分析了来自 6 篇文章的数据,包括 391 例脑外伤病例。结果显示,益生菌疗法能提高平均年龄超过 50 岁的患者的格拉斯哥昏迷量表评分。然而,接受益生菌治疗组与对照组在序贯器官功能衰竭评估和急性生理学与慢性健康评估得分上没有明显差异。虽然益生菌治疗对重症监护室的入院率(或住院时间)没有明显影响,但益生菌组的感染风险和死亡率明显降低(OR:0.53;95% CI:0.3-0.8;OR:0.41;95% CI:0.2-0.7):总之,由于益生菌能改变微生物菌群,因此益生菌补充剂能平衡微生物菌群紊乱,进而改善脑损伤患者的临床疗效。因此,以益生菌为基础的疗法可被视为治疗中枢神经系统疾病的一种前景广阔的策略。然而,由于证据有限,我们需要更多的临床试验研究来加强我们的研究结果。
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引用次数: 0
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