Clinical Microbiology Reviews最新文献

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Congenital Syphilis: a Review of Global Epidemiology. 先天性梅毒:全球流行病学回顾。
IF 36.8 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-06-21 Epub Date: 2023-03-15 DOI: 10.1128/cmr.00126-22
Leeyan S Gilmour, Tony Walls
{"title":"Congenital Syphilis: a Review of Global Epidemiology.","authors":"Leeyan S Gilmour, Tony Walls","doi":"10.1128/cmr.00126-22","DOIUrl":"10.1128/cmr.00126-22","url":null,"abstract":"<p><p>In 2007, the World Health Organization (WHO) launched a global health initiative for the elimination of mother-to-child transmission (MTCT) of syphilis. This condition is highly preventable through antenatal identification of syphilis infection and treatment with penicillin during pregnancy. This review summarizes the global status of MTCT of syphilis and concludes that this condition remains a significant issue worldwide. There are large variations in case rates by region, with the highest numbers of cases in the African and Eastern Mediterranean regions, where there are also the least data available. There are also pockets of high-incidence areas within the other regions. Although the general trend is of decreasing rates over time, there are concerning indications of consistently increasing congenital syphilis cases in some areas, particularly in areas which have previously had very low case numbers. A concerted effort will be required to achieve the 2007 WHO goal of worldwide elimination of MTCT of syphilis in the near future.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 2","pages":"e0012622"},"PeriodicalIF":36.8,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10283482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9759571","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}
引用次数: 0
Therapeutics for Vancomycin-Resistant Enterococcal Bloodstream Infections. 治疗耐万古霉素肠球菌血流感染的药物。
IF 19 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-06-21 Epub Date: 2023-04-17 DOI: 10.1128/cmr.00059-22
Kelly A Cairns, Andrew A Udy, Trisha N Peel, Iain J Abbott, Michael J Dooley, Anton Y Peleg
{"title":"Therapeutics for Vancomycin-Resistant Enterococcal Bloodstream Infections.","authors":"Kelly A Cairns, Andrew A Udy, Trisha N Peel, Iain J Abbott, Michael J Dooley, Anton Y Peleg","doi":"10.1128/cmr.00059-22","DOIUrl":"10.1128/cmr.00059-22","url":null,"abstract":"<p><p>Vancomycin-resistant enterococci (VRE) are common causes of bloodstream infections (BSIs) with high morbidity and mortality rates. They are pathogens of global concern with a limited treatment pipeline. Significant challenges exist in the management of VRE BSI, including drug dosing, the emergence of resistance, and the optimal treatment for persistent bacteremia and infective endocarditis. Therapeutic drug monitoring (TDM) for antimicrobial therapy is evolving for VRE-active agents; however, there are significant gaps in the literature for predicting antimicrobial efficacy for VRE BSIs. To date, TDM has the greatest evidence for predicting drug toxicity for the three main VRE-active antimicrobial agents daptomycin, linezolid, and teicoplanin. This article presents an overview of the treatment options for VRE BSIs, the role of antimicrobial dose optimization through TDM in supporting clinical infection management, and challenges and perspectives for the future.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 2","pages":"e0005922"},"PeriodicalIF":19.0,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10283489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9697400","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}
引用次数: 0
Host Immunity and Immunization Strategies for Clostridioides difficile Infection. 艰难梭菌感染的宿主免疫和免疫策略。
IF 36.8 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-06-21 Epub Date: 2023-05-10 DOI: 10.1128/cmr.00157-22
Farha Naz, William A Petri
{"title":"Host Immunity and Immunization Strategies for Clostridioides difficile Infection.","authors":"Farha Naz, William A Petri","doi":"10.1128/cmr.00157-22","DOIUrl":"10.1128/cmr.00157-22","url":null,"abstract":"<p><p>Clostridioides difficile infection (CDI) represents a significant challenge to public health. C. difficile-associated mortality and morbidity have led the U.S. CDC to designate it as an urgent threat. Moreover, recurrence or relapses can occur in up to a third of CDI patients, due in part to antibiotics being the primary treatment for CDI and the major cause of the disease. In this review, we summarize the current knowledge of innate immune responses, adaptive immune responses, and the link between innate and adaptive immune responses of the host against CDI. The other major determinants of CDI, such as C. difficile toxins, the host microbiota, and related treatments, are also described. Finally, we discuss the known therapeutic approaches and the current status of immunization strategies for CDI, which might help to bridge the knowledge gap in the generation of therapy against CDI.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 2","pages":"e0015722"},"PeriodicalIF":36.8,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10283484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9706103","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}
引用次数: 0
An Overlooked and Underrated Endemic Mycosis-Talaromycosis and the Pathogenic Fungus Talaromyces marneffei. 被忽视和低估的地方性真菌病--马拉色菌病和致病真菌马拉色菌(Talaromyces marneffei)。
IF 36.8 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-03-23 Epub Date: 2023-01-17 DOI: 10.1128/cmr.00051-22
Fang Wang, RunHua Han, Shi Chen
{"title":"An Overlooked and Underrated Endemic Mycosis-Talaromycosis and the Pathogenic Fungus Talaromyces marneffei.","authors":"Fang Wang, RunHua Han, Shi Chen","doi":"10.1128/cmr.00051-22","DOIUrl":"10.1128/cmr.00051-22","url":null,"abstract":"<p><p>Talaromycosis is an invasive mycosis endemic in tropical and subtropical Asia and is caused by the pathogenic fungus Talaromyces marneffei. Approximately 17,300 cases of T. marneffei infection are diagnosed annually, and the reported mortality rate is extremely high (~1/3). Despite the devastating impact of talaromycosis on immunocompromised individuals, particularly HIV-positive persons, and the increase in reported occurrences in HIV-uninfected persons, diagnostic and therapeutic approaches for talaromycosis have received far too little attention worldwide. In 2021, scientists living in countries where talaromycosis is endemic raised a global demand for it to be recognized as a neglected tropical disease. Therefore, <i>T. marneffei</i> and the infectious disease induced by this fungus must be treated with concern. <i>T. marneffei</i> is a thermally dimorphic saprophytic fungus with a complicated mycological growth process that may produce various cell types in its life cycle, including conidia, hyphae, and yeast, all of which are associated with its pathogenicity. However, understanding of the pathogenic mechanism of <i>T. marneffei</i> has been limited until recently. To achieve a holistic view of <i>T. marneffei</i> and talaromycosis, the current knowledge about talaromycosis and research breakthroughs regarding <i>T. marneffei</i> growth biology are discussed in this review, along with the interaction of the fungus with environmental stimuli and the host immune response to fungal infection. Importantly, the future research directions required for understanding this serious infection and its causative pathogenic fungus are also emphasized to identify solutions that will alleviate the suffering of susceptible individuals worldwide.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 1","pages":"e0005122"},"PeriodicalIF":36.8,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9579992","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}
引用次数: 0
The mRNA Vaccine Technology Era and the Future Control of Parasitic Infections. mRNA 疫苗技术时代与寄生虫感染的未来控制。
IF 19 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-03-23 Epub Date: 2023-01-10 DOI: 10.1128/cmr.00241-21
Hong You, Malcolm K Jones, Catherine A Gordon, Alexa E Arganda, Pengfei Cai, Harry Al-Wassiti, Colin W Pouton, Donald P McManus
{"title":"The mRNA Vaccine Technology Era and the Future Control of Parasitic Infections.","authors":"Hong You, Malcolm K Jones, Catherine A Gordon, Alexa E Arganda, Pengfei Cai, Harry Al-Wassiti, Colin W Pouton, Donald P McManus","doi":"10.1128/cmr.00241-21","DOIUrl":"10.1128/cmr.00241-21","url":null,"abstract":"<p><p>Despite intensive long-term efforts, with very few exceptions, the development of effective vaccines against parasitic infections has presented considerable challenges, given the complexity of parasite life cycles, the interplay between parasites and their hosts, and their capacity to escape the host immune system and to regulate host immune responses. For many parasitic diseases, conventional vaccine platforms have generally proven ill suited, considering the complex manufacturing processes involved and the costs they incur, the inability to posttranslationally modify cloned target antigens, and the absence of long-lasting protective immunity induced by these antigens. An effective antiparasite vaccine platform is required to assess the effectiveness of novel vaccine candidates at high throughput. By exploiting the approach that has recently been used successfully to produce highly protective COVID mRNA vaccines, we anticipate a new wave of research to advance the use of mRNA vaccines to prevent parasitic infections in the near future. This article considers the characteristics that are required to develop a potent antiparasite vaccine and provides a conceptual foundation to promote the development of parasite mRNA-based vaccines. We review the recent advances and challenges encountered in developing antiparasite vaccines and evaluate the potential of developing mRNA vaccines against parasites, including those causing diseases such as malaria and schistosomiasis, against which vaccines are currently suboptimal or not yet available.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 1","pages":"e0024121"},"PeriodicalIF":19.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9944172","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}
引用次数: 0
Antiviral Approaches against Influenza Virus. 针对流感病毒的抗病毒方法。
IF 19 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-03-23 Epub Date: 2023-01-16 DOI: 10.1128/cmr.00040-22
Rashmi Kumari, Suresh D Sharma, Amrita Kumar, Zachary Ende, Margarita Mishina, Yuanyuan Wang, Zackary Falls, Ram Samudrala, Jan Pohl, Paul R Knight, Suryaprakash Sambhara
{"title":"Antiviral Approaches against Influenza Virus.","authors":"Rashmi Kumari, Suresh D Sharma, Amrita Kumar, Zachary Ende, Margarita Mishina, Yuanyuan Wang, Zackary Falls, Ram Samudrala, Jan Pohl, Paul R Knight, Suryaprakash Sambhara","doi":"10.1128/cmr.00040-22","DOIUrl":"10.1128/cmr.00040-22","url":null,"abstract":"<p><p>Preventing and controlling influenza virus infection remains a global public health challenge, as it causes seasonal epidemics to unexpected pandemics. These infections are responsible for high morbidity, mortality, and substantial economic impact. Vaccines are the prophylaxis mainstay in the fight against influenza. However, vaccination fails to confer complete protection due to inadequate vaccination coverages, vaccine shortages, and mismatches with circulating strains. Antivirals represent an important prophylactic and therapeutic measure to reduce influenza-associated morbidity and mortality, particularly in high-risk populations. Here, we review current FDA-approved influenza antivirals with their mechanisms of action, and different viral- and host-directed influenza antiviral approaches, including immunomodulatory interventions in clinical development. Furthermore, we also illustrate the potential utility of machine learning in developing next-generation antivirals against influenza.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 1","pages":"e0004022"},"PeriodicalIF":19.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294316","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}
引用次数: 0
Human Listeriosis. 人类李斯特菌病
IF 36.8 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-03-23 Epub Date: 2022-12-08 DOI: 10.1128/cmr.00060-19
Merel M Koopmans, Matthijs C Brouwer, José A Vázquez-Boland, Diederik van de Beek
{"title":"Human Listeriosis.","authors":"Merel M Koopmans, Matthijs C Brouwer, José A Vázquez-Boland, Diederik van de Beek","doi":"10.1128/cmr.00060-19","DOIUrl":"10.1128/cmr.00060-19","url":null,"abstract":"<p><p>Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that can cause severe invasive infections upon ingestion with contaminated food. Clinically, listerial disease, or listeriosis, most often presents as bacteremia, meningitis or meningoencephalitis, and pregnancy-associated infections manifesting as miscarriage or neonatal sepsis. Invasive listeriosis is life-threatening and a main cause of foodborne illness leading to hospital admissions in Western countries. Sources of contamination can be identified through international surveillance systems for foodborne bacteria and strains' genetic data sharing. Large-scale whole genome studies have increased our knowledge on the diversity and evolution of L. monocytogenes, while recent pathophysiological investigations have improved our mechanistic understanding of listeriosis. In this article, we present an overview of human listeriosis with particular focus on relevant features of the causative bacterium, epidemiology, risk groups, pathogenesis, clinical manifestations, and treatment and prevention.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 1","pages":"e0006019"},"PeriodicalIF":36.8,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9586365","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}
引用次数: 15
Agnostic Sequencing for Detection of Viral Pathogens. 检测病毒病原体的不可知论测序。
IF 36.8 1区 医学
Clinical Microbiology Reviews Pub Date : 2023-03-23 Epub Date: 2023-02-27 DOI: 10.1128/cmr.00119-22
Nick P G Gauthier, Samuel D Chorlton, Mel Krajden, Amee R Manges
{"title":"Agnostic Sequencing for Detection of Viral Pathogens.","authors":"Nick P G Gauthier, Samuel D Chorlton, Mel Krajden, Amee R Manges","doi":"10.1128/cmr.00119-22","DOIUrl":"10.1128/cmr.00119-22","url":null,"abstract":"<p><p>The advent of next-generation sequencing (NGS) technologies has expanded our ability to detect and analyze microbial genomes and has yielded novel molecular approaches for infectious disease diagnostics. While several targeted multiplex PCR and NGS-based assays have been widely used in public health settings in recent years, these targeted approaches are limited in that they still rely on <i>a priori</i> knowledge of a pathogen's genome, and an untargeted or unknown pathogen will not be detected. Recent public health crises have emphasized the need to prepare for a wide and rapid deployment of an agnostic diagnostic assay at the start of an outbreak to ensure an effective response to emerging viral pathogens. Metagenomic techniques can nonspecifically sequence all detectable nucleic acids in a sample and therefore do not rely on prior knowledge of a pathogen's genome. While this technology has been reviewed for bacterial diagnostics and adopted in research settings for the detection and characterization of viruses, viral metagenomics has yet to be widely deployed as a diagnostic tool in clinical laboratories. In this review, we highlight recent improvements to the performance of metagenomic viral sequencing, the current applications of metagenomic sequencing in clinical laboratories, as well as the challenges that impede the widespread adoption of this technology.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"36 1","pages":"e0011922"},"PeriodicalIF":36.8,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9944638","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}
引用次数: 0
The Changing Paradigm of Drug-Resistant Tuberculosis Treatment: Successes, Pitfalls, and Future Perspectives. 耐药结核病治疗模式的变化:成功、陷阱和未来展望。
IF 36.8 1区 医学
Clinical Microbiology Reviews Pub Date : 2022-12-21 Epub Date: 2022-10-06 DOI: 10.1128/cmr.00180-19
Navisha Dookie, Senamile L Ngema, Rubeshan Perumal, Nikita Naicker, Nesri Padayatchi, Kogieleum Naidoo
{"title":"The Changing Paradigm of Drug-Resistant Tuberculosis Treatment: Successes, Pitfalls, and Future Perspectives.","authors":"Navisha Dookie,&nbsp;Senamile L Ngema,&nbsp;Rubeshan Perumal,&nbsp;Nikita Naicker,&nbsp;Nesri Padayatchi,&nbsp;Kogieleum Naidoo","doi":"10.1128/cmr.00180-19","DOIUrl":"10.1128/cmr.00180-19","url":null,"abstract":"<p><p>Drug-resistant tuberculosis (DR-TB) remains a global crisis due to the increasing incidence of drug-resistant forms of the disease, gaps in detection and prevention, models of care, and limited treatment options. The DR-TB treatment landscape has evolved over the last 10 years. Recent developments include the remarkable activity demonstrated by the newly approved anti-TB drugs bedaquiline and pretomanid against Mycobacterium tuberculosis. Hence, treatment of DR-TB has drastically evolved with the introduction of the short-course regimen for multidrug-resistant TB (MDR-TB), transitioning to injection-free regimens and the approval of the 6-month short regimens for rifampin-resistant TB and MDR-TB. Moreover, numerous clinical trials are under way with the aim to reduce pill burden and shorten the DR-TB treatment duration. While there have been apparent successes in the field, some challenges remain. These include the ongoing inclusion of high-dose isoniazid in DR-TB regimens despite a lack of evidence for its efficacy and the inclusion of ethambutol and pyrazinamide in the standard short regimen despite known high levels of background resistance to both drugs. Furthermore, antimicrobial heteroresistance, extensive cavitary disease and intracavitary gradients, the emergence of bedaquiline resistance, and the lack of biomarkers to monitor DR-TB treatment response remain serious challenges to the sustained successes. In this review, we outline the impact of the new drugs and regimens on patient treatment outcomes, explore evidence underpinning current practices on regimen selection and duration, reflect on the disappointments and pitfalls in the field, and highlight key areas that require continued efforts toward improving treatment approaches and rapid biomarkers for monitoring treatment response.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"35 4","pages":"e0018019"},"PeriodicalIF":36.8,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9769521/pdf/cmr.00180-19.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9185549","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}
引用次数: 2
The Microbial Etiology of Community-Acquired Pneumonia in Adults: from Classical Bacteriology to Host Transcriptional Signatures. 成人社区获得性肺炎的微生物病因:从经典细菌学到宿主转录特征。
IF 36.8 1区 医学
Clinical Microbiology Reviews Pub Date : 2022-12-21 Epub Date: 2022-09-27 DOI: 10.1128/cmr.00015-22
Naomi J Gadsby, Daniel M Musher
{"title":"The Microbial Etiology of Community-Acquired Pneumonia in Adults: from Classical Bacteriology to Host Transcriptional Signatures.","authors":"Naomi J Gadsby,&nbsp;Daniel M Musher","doi":"10.1128/cmr.00015-22","DOIUrl":"10.1128/cmr.00015-22","url":null,"abstract":"<p><p>All modern advances notwithstanding, pneumonia remains a common infection with substantial morbidity and mortality. Understanding of the etiology of pneumonia continues to evolve as new techniques enable identification of already known organisms and as new organisms emerge. We now review the etiology of pneumonia (at present often called \"community-acquired pneumonia\") beginning with classic bacteriologic techniques, which identified Streptococcus pneumoniae as the overwhelmingly common cause, to more modern bacteriologic studies, which emphasize Haemophilus influenzae, Staphylococcus aureus, Moraxella catarrhalis, <i>Enterobacteriaceae</i>, Pseudomonas, and normal respiratory flora. Urine antigen detection is useful in identifying <i>Legionella</i> and pneumococcus. The low yield of bacteria in recent studies is due to the failure to obtain valid sputum samples before antibiotics are administered. The use of high-quality sputum specimens enables identification of recognized (\"typical\") bacterial pathogens as well as a role for commensal bacteria (\"normal respiratory flora\"). Nucleic acid amplification technology for viruses has revolutionized diagnosis, showing the importance of viral pneumonia leading to hospitalization with or without coinfecting bacterial organisms. Quantitative PCR study of sputum is in its early stages of application, but regular detection of high counts of bacterial DNA from organisms that are not seen on Gram stain or grown in quantitative culture presents a therapeutic dilemma. This finding may reflect the host microbiome of the respiratory tract, in which case treatment may not need to be given for them. Finally, host transcriptional signatures might enable clinicians to distinguish between viral and bacterial pneumonia, an important practical consideration.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"35 4","pages":"e0001522"},"PeriodicalIF":36.8,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9769922/pdf/cmr.00015-22.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10606934","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}
引用次数: 11
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