Distribution Of Pathogens Research Articles

The clinical application value of multi-site mNGS detection of patients with sepsis in intensive care units

BackgroundSepsis remains a leading cause of mortality in intensive care units, and rapid and accurate pathogen detection is crucial for effective treatment. This study evaluated the clinical application of multi-site metagenomic next-generation sequencing (mNGS) for the diagnosis of sepsis, comparing its performance against conventional methods.MethodsA retrospective analysis was conducted on 69 patients with sepsis consecutively admitted to the Department of Intensive Care Medicine, Meizhou People’s Hospital. Samples of peripheral blood and infection sites were collected for mNGS and conventional method tests to compare the positive rate of mNGS and traditional pathogen detection methods and the distribution of pathogens. The methods used in this study included a comprehensive analysis of pathogen consistency between peripheral blood and infection site samples. Additionally, the correlation between the pathogens detected and clinical outcomes was investigated.ResultsOf the patients with sepsis, 57.97% experienced dyspnea, and 65.2% had underlying diseases, with hypertension being the most common. mNGS demonstrated a significantly higher pathogen detection rate (88%) compared to the conventional method tests (26%). The pathogen consistency rate was 60% between plasma and bronchoalveolar lavage fluid samples, and that of plasma and local body fluid samples was 63%. The most frequently detected pathogens were gram-negative bacteria, and Klebsiella pneumonia. There were no significant differences in the clinical features between the pathogens.ConclusionmNGS is significantly superior to conventional methods in pathogen detection. There was a notable high pathogen consistency detection between blood and local body fluid samples, supporting the clinical relevance of mNGS. This study highlights the superiority of mNGS in detecting a broad spectrum of pathogens quickly and accurately.Trial registrationNot applicable.

Changes in the Distribution of Pathogens Causing Meningoencephalitis Before and During the COVID-19 Pandemic.

Infectious meningoencephalitis (ME) is a major global health concern. Viruses are the most frequently implicated etiologies, whereas bacterial causes, although life-threatening, constitute a lesser proportion of ME cases, together with other pathogens. The strict implementation of COVID-19 mitigation measures led to the decreased viral and non-viral infectious diseases. Therefore, this study aimed to investigate the effect of these mea-sures on ME-causing pathogens by age groups. This retrospective study aimed to determine and compare the rates of pathogen-positive ME cases during the pre-pandemic (P-1) and pandemic (P-2) periods. Molecular diagnostic methods using the cerebrospinal fluid of patients from all age groups were included. The positivity rate difference of the ME-causing pathogens between the two study periods was compared and the distribution pattern of the pathogens among the age groups was determined. The overall positivity rate for at least one ME-causing pathogen during P-1 was 22.0% (503/2,284), which significantly declined to 7.3% (83/1,141) during P-2 (p < 0.001). Particularly, a statistically significant decline in the pathogen positivity was observed in the groups 4 - 6 (≥ 3 years) (p < 0.001, p < 0.001, and p = 0.041, respectively). Specifically, the enterovirus cases decreased significantly, whereas the varicella zoster virus and herpes simplex virus-2 cases increased. Among bacterial causes, the S. agalactiae, S. pneumoniae, and E. coli K1 ME cases significantly increased. Men and women had no significant differences in the positivity rate during either study period. COVID-19 mitigation measures significantly impacted the positivity rates and the distribution of ME-causing agents, especially in the age groups ≥ 3 years, although not uniformly.

Trends and antibiotic susceptibility patterns of diarrhoeal pathogens - experience over 14 years in southern India.

Introduction. Enteric pathogens contribute significantly to morbidity in a developing country such as India. Early and prompt diagnosis of diarrhoeal diseases can reduce the mortality rate, particularly in children. The pattern of sensitivity to antimicrobials for the common pathogens can vary from time to time. The present study was conducted to study the pathogen distribution and antimicrobial susceptibility pattern during the study period (January 2010 to December 2023). Hypothesis/gap statement. Studying the changing trend in the antimicrobial sensitivity pattern of diarrhoeal pathogens over a decade can help to plan future treatment options. Aim. This study was undertaken to provide insights into the changing pattern of pathogen distribution and antimicrobial susceptibility for enteric pathogens over 14 years. Methods. A retrospective observational cohort analysis was conducted on all the stool pathogens isolated from the samples received in the microbiology department of a tertiary care hospital from 2010 to 2023. The demographic details, stool microscopy, culture reports, and antimicrobial susceptibility patterns were noted. Results. A total of 18 336 stool specimens were received in the microbiology laboratory between January 2010 and December 2023, of which 1354 specimens had diarrhoeal pathogens grown in culture. Out of these 1354 specimens, 591 (44%) had Salmonella, 471 (35%) Shigella, 181 (13%) Vibrio cholerae, and 80 (6%) Aeromonas species. Among these pathogens, susceptibility to ceftriaxone was seen in 93% (552 isolates) of Salmonella species, 89% (420 isolates) of Shigella species, and 95% (171 isolates) of Vibrio cholerae; 91% (73 isolates) of Aeromonas species were susceptible to chloramphenicol. Some major parasites were also observed on microscopy. Conclusion. Timely diagnosis of diarrhoeal pathogens can be life-saving for patients at the extremes of age, i.e. in children and the elderly. Pathogens can exhibit a changing susceptibility pattern to antibiotics, which should be regularly observed to plan future therapy.

Analysis of the Pathogen Distribution and Antimicrobial Resistance after Plastic Surgery of the Urogenital System.

We aimed to summarize the distribution of pathogenic bacteria for postoperative infection of different genitourinary plastic surgery and the antimicrobial resistance of the major pathogens. Between January 2011 and December 2021, following plastic surgery of the urogenital system, microbial strains from infected patients were collected, identified, and counted. The antibiotic sensitivity and distribution characteristics of common pathogens in relation with the surgical procedures were studied by WHONET 5.6, along with the main bacteria accounting for early infection. A total of 76 cases were included in the study. Among these, 53 Gram-negative bacteria were detected, with Escherichia coli (18 of 53) and Pseudomonas aeruginosa (nine of 53) accounting for the majority. There were also 23 Gram-positive bacteria, among which Staphylococcus aureus (six of 23) and Coagulase-negative Staphylococcus (five of 23) were the most common. In terms of antimicrobial resistance, E. coli was highly sensitive to amikacin, piperacillin/tazobactam, cefoxitin, and imipenem, whereas P. aeruginosa was highly sensitive to gentamicin, amikacin, cefepime, piperacillin/tazobactam, imipenem, ceftazidime, and ciprofloxacin. Procedures for urethral repair, urethral reconstruction, and lump resection were most commonly associated with infection. Among these, urethral repair was responsible for the majority of infections. The pathogenic bacteria involved in postoperative infections varied overall, but the most prevalent was E. coli. Gram-negative bacteria are the major cause of infection following genitourinary plastic surgery. The specific bacterial strains, degrees of antimicrobial resistance, and length of infection varied among the various procedures. The results of this study may provide references for clinical medication and the prevention and control of such infections.

Prevalence and antimicrobial resistance of bacterial meningitis in China from 2017 to 2021: a multicenter retrospective study.

This study aims to investigate the changing epidemiology and antimicrobial susceptibility of bacteria isolated from cerebrospinal fluid (CSF) in the Shandong region. We conducted a retrospective analysis of bacterial distribution and resistance patterns in CSF samples, utilizing data from the SPARSS network and analyzed with WHONET 5.6 software. A total of 3968 pathogenic bacterial strains were isolated, consisting of 70.6% Gram-positive bacteria, 27.2% Gram-negative bacteria, and 0.2% fungi. The six most commonly detected bacteria were coagulase-negative staphylococcus, Acinetobacter baumannii, Klebsiella pneumoniae, Streptococcus pneumoniae, Escherichia coli, and staphylococcus aureus. Analysis revealed gender and seasonal variations in the distribution of CSF pathogens, with a higher incidence observed in males and during autumn compared to other seasons. The susceptibility profiles of these bacterial species varied significantly, with many exhibiting multidrug resistances. A. baumannii showed a high resistance rate to cephalosporins and carbapenems but was sensitive to tigecycline and polymyxins. For treating multidrug-resistant A. baumannii infections, polymyxin-based combinations with tigecycline or sulbactam are recommended for adults, while tigecycline combined with meropenem is suggested for children. Enterobacteriaceae species were generally sensitive to carbapenems, such as meropenem and other carbapenems that can penetrate the blood-brain barrier can be recommended. Linezolid and vancomycin are the first choice for treating common gram-positive bacterial infections. The high resistance rates observed among common CSF isolates and their varied distributions across different demographics highlight the necessity for customized treatment strategies.

Analysis of Pathogen Detection Data in 898 Pediatric Patients Hospitalized with Community-Acquired Pneumonia

Introduction: The prevalence of community-acquired pneumonia (CAP) in pediatric patients has seen significant changes following the lifting of COVID-19 restrictions. This study examines the epidemiology and pathogen detection in children hospitalized with CAP at Beijing New Century Children's Hospital throughout 2023. Objective: To analyze the pathogen detection rates and distribution characteristics among 898 pediatric CAP patients admitted during 2023, focusing on age-related and seasonal variations. Methods: This retrospective study included 898 pediatric patients diagnosed with CAP between January 1 and December 31, 2023. Respiratory pathogen detection was performed using a combination of antigen detection kits, nucleic acid testing, and bacterial culture. The data were analyzed for pathogen distribution across different age groups and seasons. Results: Of the 898 CAP cases, pathogens were detected in 703 cases (78.3%). Mycoplasma pneumoniae was the most frequently identified pathogen (44.1%), with detection rates increasing significantly with age, particularly in school-aged children. Viral pathogens were detected in 42.7% of cases, with Respiratory Syncytial Virus (32.4%) being the most prevalent. Bacterial pathogens were identified in 49.5% of cases, with Streptococcus pneumoniae (34.1%) and Haemophilus influenzae (33.0%) being the most common. Mixed infections were observed in 64.4% of cases, with a higher prevalence in older children and during the autumn and winter seasons. Conclusions: The study highlights significant age and seasonal variations in pathogen distribution among pediatric CAP patients. Mycoplasma pneumoniae was more common in older children and during autumn, while bacterial infections peaked in winter. The findings emphasize the need for age and season-specific strategies in managing pediatric CAP and suggest that comprehensive diagnostic approaches are crucial to accurately identify the causative pathogens.

Distribution of Bovine Mastitis Pathogens in Quarter Milk Samples from Bavaria, Southern Germany, between 2014 and 2023-A Retrospective Study.

The objective of this study was to investigate the distribution of mastitis pathogens in quarter milk samples (QMSs) submitted to the laboratory of the Bavarian Animal Health Service (TGD) between 2014 and 2023 in general, in relation to the clinical status of the quarters, and to analyze seasonal differences in the detection risk. Each QMS sent to the TGD during this period was analyzed and tested using the California Mastitis Test (CMT). Depending on the result, QMSs were classified as CMT-negative, subclinical, or clinical if the milk character showed abnormalities. Mastitis pathogens were detected in 19% of the QMSs. Non-aureus staphylococci (NAS) were the most common species isolated from the culture positive samples (30%), followed by Staphylococcus (S.) aureus (19%), Streptococcus (Sc.) uberis (19%), and Sc. dysgalactiae (9%). In culture-positive QMSs from CMT-negative and subclinically affected quarters, the most frequently isolated pathogens were NAS (44% and 27%, respectively), followed by S. aureus (25% and 17%, respectively) and Sc. uberis (8% and 22%, respectively). In QMSs from clinically affected quarters, the most frequently isolated pathogens were Sc. uberis (32%), S. aureus (13%), Sc. dysgalactiae (11%), and Escherichia (E.) coli (11%). The distribution of NAS and Sc. uberis increased throughout the study period, while that of S. aureus decreased. From June to October, QMSs from subclinically affected quarters increased and environmental pathogens, such as Sc. uberis, were detected more frequently. In conclusion, this study highlights the dynamic nature of the distribution of mastitis pathogens, influenced by mastitis status and seasonal factors. Environmental pathogens still play an important role, especially in clinical mastitis and seasonal dependency, with the number of positive samples continuing to increase. It is therefore essential to continue mastitis control measures and to regularly monitor the spread of mastitis pathogens in order to track trends and adapt targeted prevention measures.

Distribution and Antimicrobial Resistance of Complicated Intraabdominal Infection Pathogens in Two Tertiary Hospitals in Egypt.

Background: Management of complicated intraabdominal infections (cIAIs) requires containment of the source and appropriate initial antimicrobial therapy. Identifying the local data is important to guide the empirical selection of antimicrobial therapy. In this study, we aimed to describe the pathogen distribution and antimicrobial resistance of cIAI. Methods: In two major tertiary care hospitals in Egypt, we enrolled patients who met the case definition of cIAI from October 2022 to September 2023. Blood cultures were performed using the BACTAlert system (BioMerieux, Marcy l'Etoile, France). A culture of aspirated fluid, resected material, or debridement of the infection site was performed. Identification of pathogens and antimicrobial susceptibility testing were conducted by the VITEK-2 system (BioMerieux, Marcy l'Etoile, France). Gram-negative resistance genes were identified by PCR and confirmed by whole bacterial genome sequencing using the Nextera XT DNA Library Preparation Kit and sequencing with the MiSeq Reagent Kit 600 v3 (Illumina, USA) on the Illumina MiSeq. Results: We enrolled 423 patients, 275 (65.01%) males. The median age was 61.35 (range 25-72 years). We studied 452 recovered bacterial isolates. Gram-negative bacteria were the vast majority, dominated by E. coli, followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter baumannii, and Proteus mirabilis (33.6%, 30.5%, 13.7%, 13%, and 5.4%, respectively). High rates of resistance were detected to third- and fourth-generation cephalosporins and fluoroquinolones. No resistance was detected to colistin. Resistance to amikacin and tigecycline was low among all isolates. Resistance to meropenem and ceftazidime/avibactam was moderate. ESBL genes were common in E. coli and K. pneumoniae. CTX-M15 gene was the most frequent. Among Enterobacterales, blaOXA-48 and blaNDM were the most prevalent carbapenemase genes. Pseudomonas aeruginosa isolates harbored a wide variety of carbapenemase genes (OXA, NDM, VIM, SIM, GIM, SPM, IMP, AIM), dominated by metallo-beta-lactamases. In 20.6% of isolates, we identified two or more resistance genes. Conclusion: High resistance rates were detected to third- and fourth-generation cephalosporins and fluoroquinolones. Amikacin and tigecyclines were the most active antimicrobials. Our data call for urgent implementation of antimicrobial stewardship programs and reinforcement of infection control.

Australian Group on Antimicrobial Research surveillance outcome programs - bloodstream infections and antimicrobial resistance patterns from patients less than 18 years of age, January 2020 - December 2021.

From 1 January 2020 to 31 December 2021, thirty-eight institutions across Australia submitted data to the Australian Group on Antimicrobial Resistance (AGAR) from patients aged < 18 years (AGAR-Kids). Over the two years, 1,679 isolates were reported from 1,611 patients. This AGAR-Kids report aims to describe the population of children and adolescents with bacteraemia reported to AGAR and the proportion of resistant isolates. Overall, there were 902 gram-negative isolates reported: 800 Enterobacterales, 61 Pseudomonas aeruginosa and 41 Acinetobacter spp. Among the Enterobacterales, 12.9% were resistant to third generation cephalosporins; 11.6% to gentamicin/tobramycin; and 11.2% to piperacillin-tazobactam. In total, 14.5% of Enterobacterales were multi-drug resistant (MDR). Only 3.3% of P. aeruginosa were resistant to carbapenems and 4.9% were MDR. Resistance in Acinetobacter spp was uncommon. Of 607 Staphylococcus aureus isolates, 12.9% were methicillin-resistant (MRSA). Almost half of S. aureus isolates from the Northern Territory were MRSA. In S. aureus, resistance to erythromycin was 13.2%; 12.4% to clindamycin; and 5.3% to ciprofloxacin. Resistance to all antibiotics tested was higher in MRSA. Overall, 6.5% of S. aureus were MDR, of which 65% were MRSA. Almost three-quarters of the 170 Enterococcus spp. reported were E. faecalis, and half were from patients < 1 year old. Ampicillin resistance in enterococci was 19.6%. Eight isolates were vancomycin resistant and three isolates were teicoplanin resistant. Five E. faecium isolates were classified as MDR. This AGAR-Kids report highlights clear differences in the geographic distribution of pathogens and resistance profiles across Australia.

CLINICAL STUDY OF BODY MASS INDEX ON WOUND INFECTION AND HEALING EFFECTS

Background: Obesity, characterized by excess fat accumulation, is associated with heightened inflammation and infection risk. However, the relationship between body mass index (BMI) and wound healing remains unclear. Objective: The study aimed to explore the relationship between BMI and wound infection incidence, pathogenic bacterial strains in wounds, and wound healing promotion using different BMI values in conventional medical dressings. Methods: The study included 120 patients with traumatic and orthopedic wound infections and 40 patients with vertebral fractures to assess dressing efficacy and the influence of BMI index on healing outcomes. Wound infection incidence rates, pathogenic bacteria distribution within groups, and antibiotic resistance were identified, and their association with BMI was evaluated. Factors contributing to wound infection were analyzed. Results: The wound infection incidence rate was 30.36% without statistically significant correlation with BMI ([Formula: see text]). A weak correlation ([Formula: see text]) was established between the distribution of pathogenic bacterial strains with cause of trauma and BMI ([Formula: see text]). Wound exposure time ([Formula: see text]), wound depth ([Formula: see text]), and hospital stay ([Formula: see text]) were identified as independent wound infection risk factors. Conclusions: BMI exhibited a weak correlation with pathogenic bacteria distribution and negatively correlated with the degree of wound healing.

Identification of Lower Respiratory Tract Pathogens in Cancer Patients: Insights into Fatal Outcomes.

This study aimed to investigate LRTIs in cancer patients, focusing on pathogen distribution, and outcomes based on tumor types and antimicrobial treatments. The study included 110 cancer patients exhibiting symptoms of lower respiratory tract infections (LRTIs), consisting of 67 males and 43 females across a wide age range from under 1 year to over 60 years old. Exclusion of SARS-CoV-2 infection was conducted before admission. In addition to classical microbiological methods, fast-track detection using Multiplex Real-Time PCR was employed, utilizing the FTD-33 test kit. The findings revealed a diverse landscape of infections, notably Klebsiella pneumoniae, Haemophilus influenzae and Staphylococcus aureus. Parainfluenza 3 and 4 viruses, rhinovirus, influenza A subtype H1N1pdm09, influenza B and C viruses, HCoV-229, HCoV-OC43, and HCoV-HKU1 were infrequently detected. Furthermore, the existence of mixed infection highlighted the complexity of disease conditions in cancer patients. An analysis of antimicrobial treatment highlighted significant variations in fatal outcomes for carbapenem and colistimethate sodium. It was concluded that mixed infections were commonly identified as potential causes of LRTIs among cancer patients, while viral infections were less frequently detected. It underscores the complexity of antimicrobial treatment outcomes.

Projected distribution and dispersal patterns of prevalent ticks and tick-borne pathogens in the Sanjiangyuan area of Qinghai province, China, under intense climatic conditions

Projected distribution and dispersal patterns of prevalent ticks and tick-borne pathogens in the Sanjiangyuan area of Qinghai province, China, under intense climatic conditions

Environmental risks in swine biogas slurry-irrigated soils: A comprehensive analysis of antibiotic residues, resistome, and bacterial pathogens

Simple anaerobic digestion is insufficient to completely remove residual parent antibiotics and antibiotic resistance genes (ARGs) from animal manure. ARG prevalence in swine biogas slurry-irrigated soils threatens human health. However, comprehensive analysis of antibiotic residues, high-resolution resistance gene profiles, and pathogenic microbiomes in biogas slurry-irrigated soils is very limited. Here, we comprehensively determined the antibiotics, resistome, and potential pathogens distribution in these soils, using high-performance liquid chromatography-tandem mass spectrometry, high-throughput quantitative PCR, and 16S rRNA gene sequencing. The results revealed a significant enrichment of tetracyclines and fluoroquinolones antibiotics and ARGs in soils with prolonged biogas slurry irrigation, with a total of 12 antibiotics, 175 unique ARGs, and 9 mobile genetic elements (MGEs) detected. Quantification of veterinary antibiotic residues (especially chlortetracycline) showed significant correlations with multiple ARGs. The abundance of ARGs and MGEs was highest in the biogas slurry-irrigated soils, denoting a tight link between the application of biogas slurry and the spread of antibiotic resistance. The presence of 50 potential pathogenic bacterial genera, including 13 with multidrug resistance, was identified. Variation partitioning, combined with hierarchical partitioning analysis, indicated that Firmicutes, MGEs, and tetracyclines were the key drivers shaping the ARG profiles in biogas slurry-irrigated soils. The findings offer insights into the mechanisms of antibiotic residue and ARGs spread from the agricultural practice of biogas slurry irrigation, underscoring the necessity of sustainable soil management to mitigate the spread of antibiotic resistance.

A Review on the Impact of Climate Change on Plant Pathogen Interactions

Climate change significantly affects plant-pathogen interactions, creating major challenges for global agriculture and food security. It alters pathogen distribution, biology, and life cycles, while also impacting plant physiology and defense mechanisms. Predictive models are crucial for forecasting pathogen spread under various climate scenarios, but they face limitations due to uncertainties and the complexity of biological interactions. Advances in biotechnology and genomics, including marker-assisted selection, gene editing, and the study of plant-microbe interactions, offer promising solutions for developing climate-resilient crops. Implementing sustainable agricultural practices, such as conservation agriculture, agroforestry, and efficient water management, is vital for enhancing resilience. Integrated Pest Management (IPM) strategies, which combine biological, cultural, and chemical methods, are essential for adaptive pest control. To support these efforts, policies and regulatory frameworks, incentive programs, and international cooperation are necessary to promote the widespread adoption of these practices. There are significant research gaps, especially in long-term monitoring and interdisciplinary studies, that are crucial for a comprehensive understanding of climate change's effects on agriculture. Addressing these challenges requires global collaborative research initiatives that facilitate the exchange of knowledge, resources, and technologies, advancing our understanding and mitigation of climate impacts on agriculture.

Surveillance of ticks (Acari: Ixodidae) and tick-borne pathogens in Eastern Central Alabama.

Similar to other states in the southeastern United States, human cases of tick-borne diseases in Alabama have risen steadily over the last 2 decades. Nevertheless, limited data have been published on ticks or tick-borne pathogen (TBP) distributions since the 1990s. To better understand the risk of tick and TBP exposure in eastern central Alabama, ticks were sampled repeatedly across 8 sites associated with recreational use during May and June of 2015 to characterize tick density and diversity. Although habitats were similar across sites, tick density varied among locations. Seven species were collected, but 97.7% of 1,310 samples were the lone star tick, Amblyomma americanum (L.), the primary vector of ehrlichial agents and the tick species most commonly linked to alpha-gal syndrome and southern tick-associated rash illness. To investigate pathogen prevalence among sites, we tested A. americanum by a multiplex qPCR assay for 5 bacterial species, including 3 Ehrlichia spp. and 2 Rickettsia spp. None of the specimens tested positive for Panola Mountain Ehrlichia or Rickettsia parkeri. However, causative agents of human ehrlichiosis, Ehrlichia chaffeensis and Ehrlichia ewingii, occurred at half of the locations with, respectively, 0.27% and 0.45% of A. americanum infected on average. In contrast, Rickettsia amblyommatis, a tick endosymbiont suspected to be nonpathogenic, was found in 54.5% of the 1119 A. americanum tested. Despite low infection rates of Ehrlichia spp. in A. americanum, high encounter rates with this species in recreational deciduous woodlands suggest a moderate risk of tick bite and a low-to-moderate risk of TBP exposure in late spring.

Microbiological Landscape of Intensive Care Unit: A Retrospective Analysis of Bacterial Pathogens and Their Implications

Introduction: The intensive care unit (ICU) is a high-risk environment for hospital-acquired infections (HAIs) due to the complex interplay of patient vulnerability, invasive procedures, and the selective pressure of antimicrobial use. Understanding the local epidemiology of bacterial pathogens is crucial for effective infection prevention and control strategies. This study aimed to characterize the bacterial profile in an ICU setting, providing insights into the prevalent pathogens and their potential implications for patient care. Methods: A retrospective cross-sectional study was conducted, encompassing patients admitted to the ICU of Bangli Hospital Bali in 2023 and 2024. Data on patient demographics, sample sources, and microbiological findings were collected from medical records. Samples included blood cultures, sputum cultures (from both endotracheal tubes and spontaneous expectoration), wound swabs, and other sterile site cultures. Microbiological identification was performed using standard laboratory techniques. Results: A total of 219 patients were included in the study. The most common sample source was blood culture (42.9%), followed by sputum culture from endotracheal tubes (39.3%). A significant proportion of cultures showed no growth (34.7%), highlighting the challenges in identifying causative pathogens in the ICU. Among the identified pathogens, Staphylococcus spp. was predominant (15.5%), followed by Stenotrophomonas maltophilia (9.6%) and coagulase-negative staphylococci (8.7%). The distribution of pathogens varied across sample sources, with Staphylococcus spp. being prevalent in sputum cultures from endotracheal tubes and Klebsiella pneumoniae in sputum cultures. Conclusion: This study underscores the dynamic nature of the microbiological landscape in the ICU. The predominance of Staphylococcus spp., Stenotrophomonas maltophilia, and other opportunistic pathogens emphasizes the need for robust infection prevention and control measures. Further research is warranted to explore the impact of these pathogens on patient outcomes and to optimize antimicrobial stewardship in this critical care setting.

Analysis of pathogen distribution and sTREM-1 and miR-126 levels in patients with pulmonary infection after craniocerebral injury.

sTREM-1H and miR-126 play crucial roles in inflammation and immune responses, yet their involvement in patients with pulmonary infection following cranial injury remains understudied. The distribution of pathogens causing infection in patients with pulmonary infection after craniocerebral injury was explored, and the changes in the levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and miR-126 in peripheral blood were analyzed. In this study, 60 patients (study group) with postoperative lung infection in craniocerebral injury treated from January 2019 to December 2, 2021, and 60 patients without lung infection were selected as the control group. The study group received anti-infection treatment. The infection pathogen of the study group was tested, and the changes of sTREM-1 and miR-126 levels in the peripheral blood of the study and control groups were recorded to explore the diagnosis and predictive Value of prognostic death. 66 pathogens were detected, including 18 gram-positive bacteria, 42 gram-negative bacteria, and 6 fungi. The sTREM-1 level was higher than the control group, and the miR-126 level was lower than the control group. By ROC curve analysis, the diagnostic AUC values of both patients were 0.907 and 0.848, respectively (P< 0.05). Compared to those in the study group, patients had decreased sTREM-1 levels and increased miR-126 levels after treatment (P< 0.05). Compared with the survival group, patients in the death group had increased sTREM-1 levels and decreased miR-126 levels, and ROC curve analysis, the predicted AUC death values were 0.854 and 0.862, respectively. Gram-negative bacteria, with increased peripheral sTREM-1 levels and decreased miR-126 levels. The levels of sTREM-1 and miR-126 have specific diagnostic and prognostic Values for pulmonary infection after craniocerebral injury. However, the study's conclusions are drawn from a limited sample and short-term data, which might limit their broader applicability. Future studies with larger populations and longitudinal designs are required to confirm these findings and determine these biomarkers' robustness across different settings. Further research should also explore how these biomarkers influence patient outcomes in craniocerebral injuries.

Analysis of Pathogen Distribution and Antimicrobial Resistance in Bone and Joint Infections Among Young Children.

This study aimed to analyze the distribution of pathogens and antimicrobial resistance in bone and joint infections (BJIs) among children under four years old. A retrospective analysis was conducted on the clinical data of children under four years old who received inpatient treatment for BJIs at the Children's Hospital of Soochow University between January 2016 and December 2022. Results of bacterial culture and antimicrobial resistance were analyzed. Among the 131 patients, 52 (39.7%) showed positive bacterial culture results. There were Gram-positive (G+) bacteria detected in 38 strains (73.07%), Gram-negative (G-) bacteria in 12 strains (23.08%), and fungi in 2 strains (3.85%). Thirty-one strains of Staphylococcus aureus (S. aureus) were detected (59.62%), including 7 MRSA strains (22.58%). The resistance rate of G+ bacteria to penicillin was 72.97%, while resistance to erythromycin and clindamycin was approximately 50%. No resistance was found against linezolid, vancomycin, and teicoplanin. G- bacteria showed a sensitivity of 100% to carbapenems, including meropenem, ertapenem, and imipenem, a resistance rate of 91.67% to ampicillin-sulbactam, and relatively high resistance rates to compound sulfamethoxazole, ampicillin/sulbactam, and piperacillin. Regional variations existed in the distribution of pathogens and antimicrobial resistance in children under four years old with BJIs. In our hospital, the most common pathogen is S. aureus, with MRSA accounting for approximately one-fourth of all S. aureus patients. Additionally, extended-spectrum β-lactamase (ESBL)-producing G- bacteria have been identified, underscoring the importance of careful consideration during empirical antibiotic therapy.

Global Case Fatality of Bacterial Meningitis During an 80-Year Period

The impact of vaccination, antibiotics, and anti-inflammatory treatment on pathogen distribution and outcome of bacterial meningitis over the past century is uncertain. To describe worldwide pathogen distribution and case fatality ratios of community-acquired bacterial meningitis. Google Scholar and MEDLINE were searched in January 2022 using the search terms bacterial meningitis and mortality. Included studies reported at least 10 patients with bacterial meningitis and survival status. Studies that selected participants by a specific risk factor, had a mean observation period before 1940, or had more than 10% of patients with health care-associated meningitis, tuberculous meningitis, or missing outcome were excluded. Data were extracted by 1 author and verified by a second author. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Random-effects models stratified by age (ie, neonates, children, adults), Human Development Index (ie, low-income or high-income countries), and decade and meta-regression using the study period's year as an estimator variable were used. Case fatality ratios of bacterial meningitis. This review included 371 studies performed in 108 countries from January 1, 1935, to December 31, 2019, describing 157 656 episodes. Of the 33 295 episodes for which the patients' sex was reported, 13 452 (40%) occurred in females. Causative pathogens were reported in 104 598 episodes with Neisseria meningitidis in 26 344 (25%) episodes, Streptococcus pneumoniae in 26 035 (25%) episodes, Haemophilus influenzae in 22 722 (22%), other bacteria in 19 161 (18%) episodes, and unidentified pathogen in 10 336 (10%) episodes. The overall case fatality ratio was 18% (95% CI, 16%-19%), decreasing from 32% (95% CI, 24%-40%) before 1961 to 15% (95% CI, 12%-19%) after 2010. It was highest in meningitis caused by Listeria monocytogenes at 27% (95% CI, 24%-31%) and pneumococci at 24% (95% CI, 22%-26%), compared with meningitis caused by meningococci at 9% (95% CI, 8%-10%) or H influenzae at 11% (95% CI, 10%-13%). Meta-regression showed decreasing case fatality ratios overall and stratified by S pneumoniae, Escherichia coli, or Streptococcus agalactiae (P < .001). In this meta-analysis with meta-regression, declining case fatality ratios of community-acquired bacterial meningitis throughout the last century were observed, but a high burden of disease remained.

Metagenomic insights into ecological risk of antibiotic resistome and mobilome in riverine plastisphere under impact of urbanization

Microplastics (MPs) are of increasing concern due to their role as reservoirs for antibiotic resistance genes (ARGs) and pathogens. To date, few studies have explored the influence of anthropogenic activities on ARGs and mobile genetic elements (MGEs) within various riverine MPs, in comparison to their natural counterparts. Here an in-situ incubation was conducted along heavily anthropogenically-impacted Houxi River to characterize the geographical pattern of antibiotic resistome, mobilome and pathogens inhabiting MPs- and leaf-biofilms. The metagenomics result showed a clear urbanization-driven profile in the distribution of ARGs, MGEs and pathogens, with their abundances sharply increasing 4.77 to 19.90 times from sparsely to densely populated regions. The significant correlation between human fecal marker crAssphage and ARG (R2 = 0.67, P=0.003) indicated the influence of anthropogenic activity on ARG proliferation in plastisphere and natural leaf surfaces. And mantel tests and random forest analysis revealed the impact of 17 socio-environmental factors, e.g., population density, antibiotic concentrations, and pore volume of materials, on the dissemination of ARGs. Partial least squares-path modeling further unveiled that intensifying human activities not only directly boosted ARGs abundance but also exerted a comparable indirect impact on ARGs propagation. Furthermore, the polyvinylchloride plastisphere created a pathogen-friendly habitat, harboring higher abundances of ARGs and MGEs, while polylactic acid are not likely to serve as vectors for pathogens in river, with a lower resistome risk score than that in leaf-biofilms. This study highlights the diverse ecological risks associated with the dissemination of ARGs and pathogens in varied MPs, offering insights for the policymaking of usage and control of plastics within urbanization.