Clinical Microbiology Reviews最新文献

{"title":"The American Society for Microbiology's evidence-based laboratory medicine practice guidelines for the diagnosis of bloodstream infections using rapid tests: a systematic review and meta-analysis.","authors":"Donna M Wolk,J Scott Parrott,N Esther Babady,A Brian Mochon,Ryan Tom,Christen Diel,Jennifer Dien Bard,Amanda Harrington,D Jane Hata,Amity L Roberts,Lindsay Boyce,J Kristie Johnson","doi":"10.1128/cmr.00137-24","DOIUrl":"https://doi.org/10.1128/cmr.00137-24","url":null,"abstract":"SUMMARYBloodstream infections (BSIs) are a significant cause of mortality and morbidity. Rapid identification of pathogens and detection of a few resistance markers from positive blood cultures are now possible through the increased availability of commercial rapid diagnostic tests, including nucleic acid amplification tests and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. This document describes the clinical utility of rapid diagnostics performed on positive blood cultures and provides evidence-based laboratory medicine guidelines for using rapid tests to diagnose BSIs in hospitalized adult and pediatric patients. This guideline was developed for use by medical (a.k.a. clinical) microbiologists, medical laboratory professionals, infectious disease clinicians, pharmacists, hospital administrators, healthcare providers, and other stakeholders associated with BSIs. A panel of experts, including medical microbiologists and experts in systematic literature review, was assembled to formulate the Population-Intervention-Comparison-Outcome (PICO) question, review the literature, and provide recommendations for using rapid tests to diagnose BSI and improve patient outcomes. A comprehensive literature search of four electronic bibliographic databases (MEDLINE, Embase, CINAHL, and Cochrane) was conducted to identify studies with measurable outcomes. The panel followed a systematic process, which included a standardized methodology for rating the certainty of the evidence and strength of recommendations using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. The panel evaluated the literature to answer the question: Does using rapid diagnostic tests improve clinical outcomes in adult and pediatric patients hospitalized with a BSI? Peer-reviewed literature was available to address three outcomes, including time to targeted therapy, mortality, and length of hospital stay. In general, the quality of the evidence was low to moderate due to the paucity of controlled, randomized clinical trial studies. However, eight recommendations were made based on evidence derived from the systematic review of the published literature. To answer the PICO question, the expert committee recommended using rapid diagnostic tests combined with active communication to decrease the time to targeted therapy and length of stay (strong recommendation). While the strength of the evidence for the impact on mortality is low, the panel supports using rapid tests to impact these outcomes. A summary of the recommendations is listed in the Executive Summary, which includes a detailed description of the background, methods, evidence summary, and rationale that supports each recommendation in the full text.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"91 1","pages":"e0013724"},"PeriodicalIF":36.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial and fungal infections in persons who inject drugs.","authors":"Jeffrey Masters, David Goodman-Meza, Danielle Russell, Laura Marks, Erin McCreary, Brendan Jacka, Kate Seear, Joshua S Davis, Gail Matthews, Marianne Martinello, Steven Y C Tong, Gregory J Dore","doi":"10.1128/cmr.00162-23","DOIUrl":"https://doi.org/10.1128/cmr.00162-23","url":null,"abstract":"<p><p>SUMMARYPersons who inject drugs are at increased risk of bacterial and fungal injecting-related infections due to many physiological, societal, and structural factors. An estimated 15 million persons inject drugs worldwide, with recent increases in the burden of injecting-related infections. Acquisition of these infections has distinct pathophysiology and microbiology related to drug supply, drug composition, and the process of injecting. Clinical management of these infections is complicated by usual factors such as the need for source control and effective antibiotics, as well as the complex challenges faced by persons who inject drugs while in hospital. These challenges include drug withdrawal, difficult pain control related to opioid tolerance, stigma, discrimination, and lack of access to outpatient parenteral antibiotic therapy, which can lead to high rates of patient-directed discharge and non-completion of treatment with subsequent poor outcomes. This review seeks to provide an evidence-based summary of what is known about the risks, epidemiology, microbiology, and presentation of injecting-related bacterial and fungal infections, as well as provide recommendations for treatment, including pharmacological considerations, opportunistic screening, multidisciplinary team care, and approaches to outpatient therapy. It also provides insight into the medicolegal and ethical considerations of care for persons who inject drugs and a first-person perspective of someone with lived experience.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0016223"},"PeriodicalIF":19.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BCG therapy in bladder cancer and its tumor microenvironment interactions.","authors":"Ni Jian, Lei Yu, Lijuan Ma, Binbin Zheng, Weiren Huang","doi":"10.1128/cmr.00212-24","DOIUrl":"10.1128/cmr.00212-24","url":null,"abstract":"<p><p>SUMMARYBacillus Calmette-Guérin (BCG) has been the standard treatment for non-muscle-invasive bladder cancer for over 30 years. Despite its proven efficacy, challenges persist, including unclear mechanisms of action, resistance in 30%-50% of patients, and significant side effects. This review presents an updated and balanced discussion of the antitumor mechanisms of BCG, focusing on its direct effects on bladder cancer and its interactions with various cell types within the bladder tumor microenvironment. Notably, recent research on the interactions between BCG and the bladder microbiome is also incorporated. We further summarize and analyze the latest preclinical and clinical studies regarding both intrinsic and adaptive resistance to BCG in bladder cancer. Based on the current understanding of BCG's therapeutic principles and resistance mechanisms, we systematically explore strategies to improve BCG-based tumor immunotherapy. These include the development of recombinant BCG, combination therapy with different drugs, optimization of therapeutic regimens and management, and the exploration of new approaches by targeting changes in the bladder microbiota and its metabolites. These measures aim to effectively address the BCG resistance in bladder cancer, reduce its toxicity, and ultimately enhance the clinical anti-tumor efficacy. Bacterial therapy, represented by genetically engineered oncolytic bacteria, has gradually emerged in the field of cancer treatment in recent years. As the only bacterial drug successfully approved for oncology use, BCG has provided decades of clinical experience. By consolidating lessons from BCG's successes and limitations, we hope to provide valuable insights for the development and application of bacterial therapies in cancer treatment.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0021224"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call for healing and unity.","authors":"Patrick D Schloss","doi":"10.1128/cmr.00043-25","DOIUrl":"10.1128/cmr.00043-25","url":null,"abstract":"","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0004325"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current perspectives in the epidemiology and control of lymphatic filariasis.","authors":"Dziedzom K de Souza, Moses J Bockarie","doi":"10.1128/cmr.00126-23","DOIUrl":"10.1128/cmr.00126-23","url":null,"abstract":"<p><p>SUMMARYLymphatic filariasis (LF), a debilitating tropical disease caused by parasitic filarial worms, <i>Wuchereria bancrofti</i>, <i>Brugia malayi</i>, and <i>Brugia timori</i>, remains a significant public health challenge in tropical and subtropical settings where the disease is endemic. The disease affects millions worldwide, leading to severe disability and social stigma. Following the World Health Assembly resolution WHA50.29 in 1997 encouraging Member States to eliminate LF as a public health problem, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) was established in 2000. The establishment of the GPELF paced the way for global eradication efforts, with commitments from non-governmental organizations and Merck donating the drug ivermectin as long as it is needed to control the disease. The advances in the diagnosis and control of LF have shown promising results, including developing novel diagnostic tools, therapeutic agents, and integrated vector management and surveillance strategies. This review explores the latest advances in our understanding of LF epidemiology, transmission assessments, clinical manifestations, and immune response to infection. We further discuss the current state of diagnostic development, treatment approaches, and control measures, highlighting the importance of continued research in the fight against this disease.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0012623"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral microbiota and respiratory diseases: advances and perspectives.","authors":"Xiaohao Liu, Fengxiang Shi, Jiawei Zeng, Jiaming Bi, Chuzi Mo, Yan Chai, Buling Wu, Shuaimei Xu","doi":"10.1128/cmr.00150-24","DOIUrl":"10.1128/cmr.00150-24","url":null,"abstract":"<p><p>SUMMARYThe oral microbiota, characterized by its complexity and density, is increasingly recognized for its significant association with respiratory diseases and their pathogenesis. Changes in the oral microbiome, including shifts in the relative abundance of certain harmful microbes, their byproducts, and virulence elements, have been linked to respiratory disease development and progression. The use of oral microbiome indicators and treatments is essential for the detection, prognosis, and management of respiratory illnesses, providing significant practical benefits. Hence, a thorough understanding of the correlation between oral microbiota and respiratory illnesses is imperative for generating novel therapeutic approaches rooted in the oral microbiota to address these ailments. This review summarizes how oral microbiota are connected to respiratory diseases, explores the mechanisms of their influence, and discusses treatment approaches.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0015024"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genital cutaneous candidiasis versus chronic recurrent vulvovaginal candidiasis: distinct diseases, different populations.","authors":"Tania Day, Jack D Sobel","doi":"10.1128/cmr.00020-25","DOIUrl":"10.1128/cmr.00020-25","url":null,"abstract":"<p><p>SUMMARYVulvovaginal candidiasis (VVC) affects over half of women during their lifetime. There are two categorization systems for VVC: uncomplicated versus complicated and acute versus recurrent. Most uncomplicated or acute cases occur in postpubertal premenopausal girls and women as sporadic vaginitis due to <i>Candida albicans</i>. Complicated VVC includes recurrent, chronic, or severe cases, presence of non-<i>albicans</i> species, and/or disease occurring in people with diabetes, immunosuppression, or pregnancy. These classification systems fail to distinguish the two distinct clinical categories of genital candidiasis: estrogen-dependent VVC and estrogen-independent cutaneous candidiasis. These entities are characterized by different pathogenesis, patient demographics, predisposing conditions, symptoms, signs, investigations, differential diagnosis, treatment, and ancillary measures. The current international and national guidelines on VVC are inadequate in their description of the clinical presentation, role and limitations of culture, biopsy findings, and management of cutaneous candidiasis. Progress toward improved patient outcomes will require the interdisciplinary collaboration of researchers and guideline authors to separate these two entities, unify terminology for each, explore the roles of medications and comorbid dermatoses, detail pragmatic and accessible diagnostic processes, define treatment goals, and discuss the long-term management strategies pertinent to each condition.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0002025"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call for the United States to continue investing in science.","authors":"Ira Blader, Felicia Goodrum, Michael J Imperiale, Arturo Casadevall, Cesar A Arias, Andreas Baumler, Carey-Ann D Burnham, Christina A Cuomo, Corrella S Detweiler, Graeme N Forrest, Jack A Gilbert, Susan Lovett, Stanley Maloy, Alexander McAdam, Irene Newton, Gemma Reguera, George A O'Toole, Patrick D Schloss, Ashley Shade, Marvin Whiteley","doi":"10.1128/cmr.00044-25","DOIUrl":"10.1128/cmr.00044-25","url":null,"abstract":"","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0004425"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum for Kramer et al., 'How long do bacteria, fungi, protozoa, and viruses retain their replication capacity on inanimate surfaces? A systematic review examining environmental resilience versus healthcare-associated infection risk by \"fomite-borne risk assessment\"'.","authors":"Axel Kramer, Franziska Lexow, Anna Bludau, Antonia Milena Köster, Martin Misailovski, Ulrike Seifert, Maren Eggers, William Rutala, Stephanie J Dancer, Simone Scheithauer","doi":"10.1128/cmr.00129-25","DOIUrl":"https://doi.org/10.1128/cmr.00129-25","url":null,"abstract":"","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0012925"},"PeriodicalIF":19.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin microbiota in atopic dermatitis: victim or executioner?","authors":"Chiara Maria Teresa Boggio, Federica Veronese, Marta Armari, Elisa Zavattaro, Elia Esposto, Paola Savoia, Barbara Azzimonti","doi":"10.1128/cmr.00277-24","DOIUrl":"https://doi.org/10.1128/cmr.00277-24","url":null,"abstract":"<p><p>SUMMARYAtopic dermatitis (AD) is a prevalent chronic inflammatory skin disorder, affecting 10%-20% of the population, characterized by dryness, intense itching, and recurrent rashes. The pathophysiology of AD is multifactorial, involving skin barrier dysfunction, immune dysregulation, genetic factors (such as filaggrin mutations), and environmental factors. The skin microbiota also plays a pivotal role in AD, serving both as a target and a driver of the disease. In AD, the delicate balance of the skin microbiota is disrupted, leading to a decrease in beneficial bacteria such as <i>Streptococcus</i>, <i>Cutibacterium</i>, and <i>Corynebacterium</i>. Concurrently, bacterial pathobionts, notably <i>Staphylococcus aureus</i>, proliferate and express their virulence factors excessively. This imbalance exacerbates symptoms by damaging the skin barrier, releasing toxins, and triggering a Th2-driven immune response, thus weakening the skin defenses and making individuals with AD more susceptible to bacterial, fungal, and viral infections, thereby complicating treatment and worsening disease outcomes. Effective AD management requires a thorough understanding of the interplay among the skin microbiota, the immune system, and microbial pathobionts. Strategies that restore the microbial balance, preserve the skin barrier, and modulate the immune response show significant potential for reducing infections and improving AD symptoms, highlighting the microbiota's dual role in AD pathology. This review examines the complex role of the skin microbiota in AD, emphasizing how dysbiosis both drives disease progression and influences immune responses, and vice versa. It also explores emerging microbiota-targeted therapies aimed at improving disease outcomes.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0027724"},"PeriodicalIF":19.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}