Infectious diseases最新文献

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Biomarkers and genotypes in patients with Central nervous system infection caused by enterovirus. 肠道病毒引起的中枢神经系统感染患者的生物标记物和基因型。

Infectious diseases

Pub Date : 2024-05-17 DOI: 10.1080/23744235.2024.2345712

Karolina Alsén, Marianela Patzi Churqui, Helene Norder, Karolina Rembeck, Henrik Zetterberg, K. Blennow, Fredrika Sahlgren, Anna Grahn

PURPOSEEnteroviruses (EV) comprises many different types and are the most common cause of aseptic meningitis. How the virus affects the brain including potential differences between types are largely unknown. Measuring biomarkers in CSF is a tool to estimate brain damage caused by CNS infections.METHODSA retrospective study was performed in samples from 38 patients with acute neurological manifestations and positive CSF-EV RNA (n = 37) or serum-IgM (n = 1). The EV in 17 samples were typed by sequencing. The biomarkers neurofilament light (NFL), glial fibrillary acidic protein (GFAP), S-100B protein, amyloid-β (Aβ) 40 and Aβ42, total-tau (T-tau) and phosphorylated tau (P-tau) were measured and compared with data derived from a control group (n = 19).RESULTSThere were no increased levels of GFAP (p ≤ 0.1) nor NFL (p ≤ 0.1) in the CSF of patients with EV meningitis (n = 38) compared with controls. However, we found decreased levels of Aβ42 (p < 0.001), Aβ40 (p < 0.001), T-tau (p ≥ 0.01), P-tau (p ≤ 0.001) and S-100B (p ≤ 0.001). E30 (n = 9) and CVB5 (n = 6) were the most frequent EV-types identified, but no differences in biomarker levels or other clinical parameters were found between the infecting virus type. Seven patients who were followed for longer than one month reported remaining cognitive impairment, although no correlations with biomarker concentrations were observed.CONCLUSIONThere are no indication of neuronal or astrocyte damage in patients with EV meningitis. Yet, decreased concentrations of Aβ40, Aβ42, P-tau and T-tau were shown, a finding of unknown importance. Cognitive impairment after acute disease occurs, but with only a limited number of patients analysed, no conclusion can be drawn concerning any association with biomarker levels or EV types.

目的脊髓灰质炎病毒（EV）有多种不同类型，是无菌性脑膜炎最常见的病因。病毒如何影响大脑，包括不同类型病毒之间的潜在差异，这些问题在很大程度上还不清楚。测量 CSF 中的生物标记物是评估中枢神经系统感染造成的脑损伤的一种工具。方法对 38 名有急性神经系统表现、CSF-EV RNA 阳性（37 人）或血清-IgM 阳性（1 人）的患者样本进行了回顾性研究。对 17 份样本中的 EV 进行了测序分型。对生物标志物神经丝光（NFL）、胶质纤维酸性蛋白（GFAP）、S-100B 蛋白、淀粉样蛋白-β（Aβ）40 和 Aβ42、总 tau（T-tau）和磷酸化 tau（P-tau）进行了测定，并与对照组（n = 19）的数据进行了比较。结果与对照组相比，EV 脑膜炎患者（n = 38）脑脊液中 GFAP（p ≤ 0.1）和 NFL（p ≤ 0.1）的水平没有增加。然而，我们发现 Aβ42 (p＜0.001)、Aβ40 (p＜0.001)、T-tau (p≥0.01)、P-tau (p≤0.001) 和 S-100B (p≤0.001) 水平下降。E30（9 例）和 CVB5（6 例）是最常见的 EV 类型，但不同感染病毒类型的生物标志物水平或其他临床参数并无差异。随访超过一个月的七名患者报告仍存在认知障碍，但未观察到与生物标志物浓度的相关性。然而，Aβ40、Aβ42、P-tau 和 T-tau 的浓度有所下降，这一发现的重要性尚不清楚。急性病后会出现认知障碍，但由于分析的患者人数有限，因此无法就生物标志物水平或 EV 类型之间的关联得出结论。

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引用次数: 0

Tonsillectomies are associated with an increased risk of meningococcal carriage. 扁桃体切除术与脑膜炎球菌携带风险增加有关。

Infectious diseases

Pub Date : 2024-05-17 DOI: 10.1080/23744235.2024.2354310

Í. Kristinsdóttir, Ásgeir Haraldsson, V. Thors

BACKGROUNDNeisseria meningitidis is a commensal organism with the potential to cause life-threatening disease. Colonisation is most common in adolescence and young adulthood. Various social factors have been associated with an increased risk of meningococcal carriage, but less is known about host factors that may influence the carriage status. Tonsillectomies have been shown to alter the pharyngeal microflora. This study assessed whether a history of tonsillectomy affects the risk of meningococcal colonisation.METHODSOropharyngeal swabs were collected from 15- to 16-year-old adolescents and 18- to 20-year-old young adults. Conventional culture methods and qPCR were used to detect meningococci. 16S qPCR was done to assess bacterial abundance in the samples. Data on history of tonsillectomies were collected from a central national database and the national university hospital.RESULTSA total of 722 samples were collected; 197 from adolescents and 525 from young adults. Thirty-five participants were colonised with meningococci (4.8%). Eighty-eight participants had undergone a tonsillectomy, of which 10 (11.4%) carried meningococci, compared to 4% of those that had not. Prior tonsillectomy was associated with a threefold increased risk of meningococcal colonisation (OR 3.10, 95% CI 1.44-6.70, p = 0.004). Tonsillectomies remained a risk factor after adjusting for age, sex, recent antibiotic use and meningococcal vaccinations (aOR 2.49, 95% CI 1.13-5.48, p = 0.024).CONCLUSIONSA history of tonsillectomy is associated with an increased risk of meningococcal colonisation. More studies are needed to shed light on the effects of tonsillectomies on the pharyngeal microbiome.

背景脑膜炎奈瑟菌是一种共生菌，有可能引发危及生命的疾病。定植最常见于青春期和青年期。各种社会因素都与脑膜炎球菌携带风险的增加有关，但对可能影响携带状况的宿主因素却知之甚少。事实证明，扁桃体切除术会改变咽部微生物区系。本研究评估了扁桃体切除术史是否会影响脑膜炎球菌定植的风险。方法从 15 到 16 岁的青少年和 18 到 20 岁的年轻人身上采集咽拭子。采用传统培养方法和 qPCR 检测脑膜炎球菌。16S qPCR 用于评估样本中细菌的丰度。结果共收集到 722 份样本，其中 197 份来自青少年，525 份来自年轻人。35名参与者体内有脑膜炎球菌（4.8%）。88名参与者接受过扁桃体切除术，其中10人（11.4%）携带脑膜炎球菌，而未接受扁桃体切除术的参与者中只有4%携带脑膜炎球菌。扁桃体切除术前感染脑膜炎球菌的风险增加了三倍（OR 3.10，95% CI 1.44-6.70，p = 0.004）。在对年龄、性别、近期抗生素使用情况和脑膜炎球菌疫苗接种情况进行调整后，扁桃体切除术仍是一个风险因素（aOR 2.49，95% CI 1.13-5.48，p = 0.024）。扁桃体切除术对咽部微生物组的影响还需要更多的研究来揭示。

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引用次数: 0

Sensitive and rapid identification of pathogens by droplet digital PCR in a cohort of septic patients: a prospective diagnostic study. 通过液滴数字 PCR 在一组脓毒症患者中灵敏、快速地识别病原体：一项前瞻性诊断研究。

Infectious diseases

Pub Date : 2024-05-16 DOI: 10.1080/23744235.2024.2354312

Zhenping Wu, Yake Yao, Xi Li, Hongliu Cai, Guobin Wang, Wenqiao Yu, Hui Lou, Qi Chen, Zhu Zeng, Hao Yu, Jiang Xia, Yunsong Yu, Hualing Zhou

BACKGROUNDThere is a critical need for a rapid and sensitive pathogen detection method for septic patients. This study aimed to investigate the diagnostic efficacy of Digital droplet polymerase chain reaction (ddPCR) in identifying pathogens among suspected septic patients.METHODSWe conducted a prospective pilot diagnostic study to clinically validate the multiplex ddPCR panel in diagnosing suspected septic patients. A total of 100 sepsis episodes of 89 patients were included in the study.RESULTSIn comparison to blood culture, the ddPCR panel exhibited an overall sensitivity of 75.0% and a specificity of 69.7%, ddPCR yielded an additional detection rate of 17.0% for sepsis cases overall, with a turnaround time of 2.5 h. The sensitivity of ddPCR in the empirical antibiotic treatment and the non-empirical antibiotic treatment group were 78.6% versus 80.0% (p > 0.05). Antimicrobial resistance genes were identified in a total of 13 samples. Whenever ddPCR detected the genes beta-lactamase-Klebsiella pneumoniae carbapenemase (blaKPC) or beta-lactamase-New Delhi metallo (blaNDM), these findings corresponded to the cultivation of carbapenem-resistant gram-negative bacteria. Dynamic ddPCR monitoring revealed a consistent alignment between the quantitative ddPCR results and the trends observed in C-reactive protein and procalcitonin levels.CONCLUSIONSCompared to blood culture, ddPCR exhibited higher sensitivity for pathogen diagnosis in suspected septic patients, and it provided pathogen and drug resistance information in a shorter time. The quantitative results of ddPCR generally aligned with the trends seen in C-reactive protein and procalcitonin levels, indicating that ddPCR can serve as a dynamic monitoring tool for pathogen load in septic patients.

背景脓毒症患者急需一种快速、灵敏的病原体检测方法。本研究旨在探讨数字液滴聚合酶链反应（ddPCR）在疑似脓毒症患者中鉴定病原体的诊断效果。方法我们开展了一项前瞻性试点诊断研究，对诊断疑似脓毒症患者的多重 ddPCR 面板进行临床验证。结果与血培养结果相比，ddPCR 鉴定小组的总体灵敏度为 75.0%，特异度为 69.7%，ddPCR 对败血症病例的总体检出率增加了 17.0%，周转时间为 2.5 h。共在 13 个样本中鉴定出抗菌药耐药基因。只要 ddPCR 检测到β-内酰胺酶-肺炎克雷伯菌碳青霉烯酶（blaKPC）或β-内酰胺酶-新德里金属酶（blaNDM）基因，这些结果就与耐碳青霉烯类革兰氏阴性菌的培养相一致。动态 ddPCR 监测显示，ddPCR 定量结果与 C 反应蛋白和降钙素原水平的变化趋势一致。ddPCR 的定量结果与 C 反应蛋白和降钙素原水平的变化趋势基本一致，这表明 ddPCR 可作为脓毒症患者病原体负荷的动态监测工具。

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引用次数: 0

Resurgence of Syphilis in the United States: An Assessment of Contributing Factors. 美国梅毒的复发：影响因素评估。

Infectious diseases

Pub Date : 2019-10-16 eCollection Date: 2019-01-01 DOI: 10.1177/1178633719883282

Rebecca Schmidt, Paul James Carson, Rick J Jansen

In the last decade, there has been a marked resurgence of syphilis in the United States despite the availability of effective treatments and previously reliable prevention strategies. The majority of cases are among the population of men who have sex with men (MSM); however, there has also been a recent increase among premenopausal women, coinciding with a concerning rise of congenital cases. The resurgence of syphilis can be largely attributed to changing social and behavioral factors, especially among young MSM. The biological association of syphilis with human immunodeficiency virus (HIV) transmission and acquisition is particularly alarming because of the increased individual and healthcare burden. In addition, some individual actions and public health efforts that are meant to reduce the risk of acquiring HIV may actually lead to risk compensation that facilitates the transmission of syphilis. Untreated syphilis is associated with detrimental health outcomes; therefore, both effective prevention strategies and treatment of this systemic disease have important short-term and long-term public health implications. This article offers a review of social and behavioral factors contributing to the current resurgence and recommendations for reducing syphilis incidence through medical and public health prevention strategies.

在过去的十年里，尽管有有效的治疗方法和以前可靠的预防策略，但梅毒在美国明显死灰复燃。大多数病例发生在与男性发生性关系的男性人群中；然而，最近绝经前妇女的发病率也有所上升，与先天性病例的上升相吻合。梅毒的死灰复燃在很大程度上可归因于社会和行为因素的变化，尤其是在年轻的男男性行为者中。梅毒与人类免疫缺陷病毒（HIV）传播和获得的生物学联系尤其令人担忧，因为个人和医疗负担增加。此外，一些旨在降低感染艾滋病毒风险的个人行动和公共卫生努力实际上可能会导致风险补偿，从而促进梅毒的传播。未经治疗的梅毒与有害的健康结果有关；因此，这种系统性疾病的有效预防策略和治疗都具有重要的短期和长期公共卫生意义。本文综述了导致当前梅毒死灰复燃的社会和行为因素，并提出了通过医疗和公共卫生预防策略降低梅毒发病率的建议。

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引用次数: 68

Demographic Determinants of Influenza Vaccination and Infection, Brazos County, Texas, 2017. 流感疫苗接种和感染的人口统计学决定因素，德克萨斯州布拉佐斯县，2017年。

Infectious diseases

Pub Date : 2019-07-15 eCollection Date: 2019-01-01 DOI: 10.1177/1178633719863815

Yao Akpalu, Ibraheem Karaye, Julie Anderson, Osaro Mgbere, Jennifer A Horney

Background: Seasonal influenza constitutes an enormous public health burden. The 2017-2018 influenza season was the most severe since the 2009 novel Influenza A (H1N1) pandemic. The State of Texas, like other states, experienced unusually high and persistent influenza activity.

Methods: Data on confirmed cases of influenza and influenza-like illness (ILI) in Brazos County during December 2017 were collected by the Brazos County Health Department (BCHD) from medical records. Records of vaccine administered between January 1 and December 31, 2017 were collected from vaccination providers. The total number of influenza cases for 2017 was compiled from regular weekly influenza counts reported to BCHD by healthcare providers.

Results: A total of 1651 cases of laboratory-confirmed influenza were reported in Brazos County residents in December 2017, 10 times more than that reported in December 2016. The highest rates of infection were in 2 ZIP codes where vaccination rates were also high. A total of 16 027 influenza vaccinations were given to individuals reporting a residential address in Brazos County in 2017. Vaccination coverage was lowest among adults aged 18 to 49, whereas those aged 65 or older and Hispanics were most likely to be hospitalized.

Discussion: Overall, vaccination coverage in Brazos County, Texas is low, less than half of the Healthy People 2020 target. The development of health education materials and an increased use of social media, local television and radio, and communication methods that can reach parents, younger adults, and Hispanic residents are needed.

背景：季节性流感构成了巨大的公共卫生负担。2017-2018年流感季节是自2009年新型甲型H1N1流感大流行以来最严重的一次。得克萨斯州和其他州一样，经历了异常高且持续的流感活动。方法：布拉佐斯县卫生部门（BCHD）从病历中收集2017年12月布拉佐斯郡流感和流感样疾病确诊病例的数据。2017年1月1日至12月31日期间接种疫苗的记录是从疫苗接种提供者那里收集的。2017年的流感病例总数是根据医疗保健提供者向BCHD报告的每周定期流感计数编制的。结果：2017年12月，布拉佐斯县居民共报告1651例实验室确诊的流感病例，是2016年12月报告的10倍。感染率最高的是2个邮政编码，那里的疫苗接种率也很高。共16个 2017年，布拉佐斯县报告居住地址的个人接种了027次流感疫苗。18至49岁的成年人的疫苗接种覆盖率最低，而65岁或65岁以上的人和西班牙裔最有可能住院。讨论：总体而言，德克萨斯州布拉佐斯县的疫苗接种覆盖率较低，不到2020年健康人群目标的一半。需要开发健康教育材料，增加社交媒体、当地电视和广播的使用，以及能够接触到父母、年轻人和西班牙裔居民的沟通方法。

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