Diagnostic microbiology and infectious disease最新文献

{"title":"High throughput HPV genotyping by next generation sequencing for detection of 28 HPV types and 13 sexually transmitted infections: A first community-based cervical cancer screening study from India","authors":"Yasasve Madhavan,&nbsp;Vasanthkumar Muthukumar,&nbsp;Srinidhi Ramasubramanian,&nbsp;Vijayalakshmi Ramshankar","doi":"10.1016/j.diagmicrobio.2026.117278","DOIUrl":"10.1016/j.diagmicrobio.2026.117278","url":null,"abstract":"<div><h3>Background</h3><div>High-risk human papillomavirus (HR-HPV) infection is the primary cause of cervical cancer. However, conventional PCR-based assays provide limited HPV genotyping, and cytology alone has low sensitivity for detecting subclinical infections. Comprehensive molecular approaches are needed to better characterize HPV genotypes and co-infections in community screening settings.</div></div><div><h3>Methods</h3><div>This study evaluated the analytical performance of a next-generation sequencing (NGS)–based HPV–STI assay in comparison with the clinically validated Roche Cobas^Ⓡ 4800 platform in a community screening cohort from South India. Cervical exfoliated cell samples from 96 asymptomatic, married women previously tested by Cobas^Ⓡ 4800 with partial HR-HPV genotyping (HPV16, HPV18, and a pooled group of 12 other high-risk types) were analyzed using NGS. The NGS assay enabled comprehensive detection of 28 HPV genotypes and 13 sexually transmitted infections (STIs) on the Illumina NextSeq 550 platform. Liquid-based cytology with RAPID-Pap staining was performed for all sequenced samples.</div></div><div><h3>Results</h3><div>The NGS assay showed high agreement with the Cobas^Ⓡ 4800 platform, with an overall concordance of 95.8% (92/96). Concordance was 94.4% (17/18) for HPV16 detection, 100% (3/3) for HPV18, 96.7% (58/60) for pooled other high-risk HPV types (non-HPV16/18), and 85.7% (7/8) for mixed infections, including co-infections of HPV16 or HPV18 with non-HPV16/18 high-risk types as well as HPV16/18 dual infections. Among women with abnormal cytology (ASCUS and HSIL), non-HPV16/18 infections were identified in 58.3% (7/12) of cases. Concurrent non-HPV STIs were detected in 52.1% (50/96) of participants, with <em>Ureaplasma parvum</em> and <em>Mycoplasma hominis</em> being the most prevalent.</div></div><div><h3>Conclusion</h3><div>A substantial proportion of women with abnormal cytology in this community cohort harboured non-HPV16 and HPV18 high-risk infections, highlighting the importance of extended HPV genotyping. NGS-based HPV genotyping was concordant with the comparator assay used and had simultaneous STI identification, supporting its potential utility as a comprehensive tool for community-based cervical cancer screening and risk stratification.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117278"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design, validation and evaluation of a triplex real time qualitative PCR assay targeting zoonotic Capnocytophaga species in EDTA whole blood and plasma simulated clinical specimens","authors":"A.M. Szewc ,&nbsp;A.C. Nicholson ,&nbsp;K. Livingston,&nbsp;C. Hopper,&nbsp;J.R. McQuiston","doi":"10.1016/j.diagmicrobio.2026.117268","DOIUrl":"10.1016/j.diagmicrobio.2026.117268","url":null,"abstract":"<div><div>Found in the oral microbiome of cats and dogs, bacteria from the genus <em>Capnocytophaga</em> occasionally infect humans and can cause serious disease or death if not identified and treated promptly. Described here is a real-time triplex qualitative PCR assay designed using gene targets (<em>rpl</em>V and secY) identified as diagnostically relevant by analysis of genomes from the <em>Capnocytophaga</em> species. The assay was evaluated on simulated EDTA whole blood samples/plasma and is effective at detecting down to 10 copies per microliter (10000 copies per mL, 4 log/mL) for whole blood samples (<em>rpl</em>V /<em>sec</em>Y), and 1 copy per microliter (1000 copies per mL, 3 log mL) (<em>rpl</em>V) and 0.5 copy per microliter (500 copies per mL, 2.69 log mL) (<em>sec</em>Y) for plasma samples. Analytical sensitivity, specificity, and reproducibility were established in plasmid-spiked simulated EDTA whole blood and plasma specimens, and clinical performance in <em>Capnocytophaga</em>-positive patient samples remains to be determined.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117268"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metagenomic next-generation sequencing in pediatric infectious disease diagnosis: A comprehensive systematic literature review and meta-analysis","authors":"Maria Celidonio Gutfreund ,&nbsp;Gustavo Yano Callado ,&nbsp;Isabele Pardo ,&nbsp;Mariana Kim Hsieh ,&nbsp;Patrícia Deffune Celeghini ,&nbsp;Gabriel O.V. Lopes ,&nbsp;Pedro S. Marra ,&nbsp;Yan Runa Cheng ,&nbsp;Takaaki Kobayashi ,&nbsp;João Renato Rebello Pinho ,&nbsp;José Roberto Generoso Jr ,&nbsp;Lucas Bulgarelli ,&nbsp;Eneida A Mendonça ,&nbsp;Rodrigo Octávio Deliberato ,&nbsp;Deyvid Emanuel Amgarten ,&nbsp;Fernanda de Mello Malta ,&nbsp;Michael B Edmond ,&nbsp;Alexandre R. Marra","doi":"10.1016/j.diagmicrobio.2025.117248","DOIUrl":"10.1016/j.diagmicrobio.2025.117248","url":null,"abstract":"<div><h3>Background</h3><div>Diagnosing pediatric infectious diseases is challenging due to nonspecific presentations, small sample volumes, and the limited sensitivity of conventional microbiological tests (CMTs). Metagenomic next-generation sequencing (mNGS) enables broad, hypothesis-free pathogen detection, but its diagnostic performance in children remains insufficiently characterized. This study evaluates the diagnostic accuracy of mNGS in pediatric infectious diseases and compares its performance with CMTs.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was registered in PROSPERO (CRD42024542444). Searches were performed using multiple databases through August 2024. Eligible studies evaluated mNGS and CMTs in pediatric patients (≤21 years) with suspected infectious diseases and compared their respective results with clinical diagnosis. Pooled sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated using a bivariate random-effects model.</div></div><div><h3>Results</h3><div>Thirty-three studies (n = 4,165) met inclusion criteria, and nine were eligible for meta-analysis. Pooled sensitivity and specificity of mNGS versus clinical diagnosis were 0.84 (95% CI: 0.82–0.86) and 0.71 (95% CI: 0.66–0.75), respectively, compared with 0.40 (95% CI: 0.37–0.43) and 0.82 (95% CI: 0.78–0.86) for CMTs. The pooled DOR favored mNGS (18.6 vs. 5.4). Respiratory infections were most frequently investigated, followed by bloodstream and mixed infections. Over two-thirds of studies reported changes in antimicrobial management following mNGS results.</div></div><div><h3>Conclusions</h3><div>mNGS demonstrates superior sensitivity and diagnostic accuracy compared with CMTs, enabling comprehensive pathogen detection, including rare and co-infecting organisms, and informing targeted antimicrobial therapy. Despite limitations related to cost, complex interpretation, and methodological standardization, mNGS represents a promising complement to conventional diagnostics in pediatric infectious disease management.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117248"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world laboratory functionality requirements and implementation considerations for fast phenotypic antimicrobial susceptibility testing","authors":"Patrick M. McDaneld ,&nbsp;Theresa Okeyo Owuor ,&nbsp;Shivaramu Keelara ,&nbsp;Carrie E. Lasky ,&nbsp;Andrea M. Prinzi","doi":"10.1016/j.diagmicrobio.2026.117279","DOIUrl":"10.1016/j.diagmicrobio.2026.117279","url":null,"abstract":"<div><div>Timely and effective antimicrobial therapy is essential for managing bacteremia and reducing associated morbidity and mortality. Fast phenotypic antimicrobial susceptibility testing (fAST) technologies offer the potential to accelerate optimal therapy by providing fast, actionable results. However, real-world adoption of fAST is influenced by laboratory infrastructure, antimicrobial stewardship practices, and the adaptability of new diagnostic platforms. We conducted an Early Evaluation Program (EEP) of the VITEK® REVEAL™ system at 13 U.S. hospital-based microbiology laboratories to assess performance and user experience related to the assay and fAST in general. A survey was performed as a component of the EEP to qualitatively assess barriers and facilitators to fAST implementation. Survey responses highlighted that ease of use, improved turnaround time, and clinical impact were the most valued features of fAST. Willingness to adopt fAST was high, but hesitations centered on evidence gaps, resource constraints, and the need for robust performance data. Key determinants of adoption included patient complexity, laboratory staffing, and workflow integration. Mapping responses to the Consolidated Framework for Implementation Research (CFIR) identified critical domains such as evidence base, adaptability, cost, and communication pathways. Successful implementation strategies included stakeholder education and engagement, consensus-building, and tailoring software to local needs. These findings highlight that while fAST can transform bacteremia management, its impact depends on addressing local barriers, fostering multidisciplinary collaboration, and ensuring ongoing evaluation of clinical and operational outcomes.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117279"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serological and molecular detection of toxoplasma gondii and Risk factor analysis among the human population of Lahore, Pakistan","authors":"Mateen Arshad,&nbsp;Zunera Shafiq,&nbsp;Ghazala Jabeen,&nbsp;Zakia Kanwal,&nbsp;Saima Sharif,&nbsp;Hafsa Javed,&nbsp;Farzana Rashid","doi":"10.1016/j.diagmicrobio.2026.117271","DOIUrl":"10.1016/j.diagmicrobio.2026.117271","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Toxoplasma gondii</em> has a global epidemiology as a common apicomplexan parasite that affects homoeothermic vertebrates, including humans. It is believed that over one billion individuals are infected globally. The study aimed to determine the seroprevalence and molecular detection of <em>T. gondii</em> among residents of Lahore, Pakistan, and to identify associated demographic and behavioral risk factors.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in which a total of 800 participants from Lahore were included. Blood samples were collected for serological testing using the Latex Agglutination Test (LAT) and the IgM-specific ELISA whereas molecular detection and genetic characterization were performed on 26 ELISA-positive samples using PCR amplification and SAG1 gene sequencing. Demographic, behavioral, and environmental risk factors were assessed through structured questionnaires. Statistical analyses were conducted using SPSS v26, with significance set at <em>p</em> ≤ 0.05.</div></div><div><h3>Results</h3><div>The result revealed LAT positivity was 55.5%, whereas ELISA detected 5.9% IgM-positive cases. PCR confirmed active infection in 2 individuals, with rare co-positivity. Higher seroprevalence was observed in females, adults aged 30–49 years, participants with lower education, and those practicing boiled water consumption or owning pets. Notably, fruit and vegetable washing practices were significantly associated with both serological and PCR positivity (<em>p</em> &lt; 0.01). Genetic analysis identified Type I <em>T. gondii</em> strains closely related to the Tg3-DRC-Eg reference strain.</div></div><div><h3>Conclusion</h3><div>The present study demonstrates the complementary roles of serological and molecular assays for accurate detection of <em>T. gondii</em>. Key demographic and behavioral factors, particularly hygiene and food-handling practices, influence local infection risk.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117271"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of parvovirus B19 infection in childhood - collection of demographic data, clinical presentation, diagnostic findings and the impact on patients with hemolytic anemia","authors":"Lorraine Lawatsch ,&nbsp;Michael Baier ,&nbsp;Till Milde ,&nbsp;Bernd Gruhn","doi":"10.1016/j.diagmicrobio.2026.117263","DOIUrl":"10.1016/j.diagmicrobio.2026.117263","url":null,"abstract":"<div><h3>Introduction</h3><div>Parvovirus B19 is a known cause of erythema infectiosum, aplastic crises and severe anemia, especially in patients with hemolytic anemia. The aim of this study was to investigate the clinical and diagnostic parameters of parvovirus B19 infection in children with and without hemolytic anemia and to record the course of case numbers in recent years.</div></div><div><h3>Methods</h3><div>We retrospectively included all patients diagnosed with acute parvovirus B19 infection at the Department of Pediatrics, Jena University Hospital, Jena, Germany between 2016 and 2024. Diagnosis was confirmed by positive parvovirus B19 IgM serology and/or PCR testing. Both demographic and clinical data as well as diagnostic parameters were collected and analyzed, focusing on differences between children with and without underlying hemolytic anemia.</div></div><div><h3>Results</h3><div>Among the 40 pediatric patients included in this study, 14 patients were diagnosed with hemolytic anemia. Children with hemolytic anemia suffered from a significantly greater hemoglobin drop and a significantly higher need for transfusion compared to children without hemolytic anemia. A Poisson regression model, adjusted for observation time, was used to compare case rates between 2016 and 2022 and 2023-2024.The model demonstrated a more than fivefold increase in parvovirus B19 cases in 2023-2024 compared to 2016-2022.</div></div><div><h3>Conclusion</h3><div>Children with hemolytic anemia, such as spherocytosis, are at higher risk of severe anemia and require more frequently transfusions during acute parvovirus B19 infection. The observed increase in cases after 2022 suggests changing epidemiological patterns and highlights the need for careful surveillance and early diagnostic and therapeutic interventions in affected children.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117263"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From pandemic influenza to novel coronaviruses: emerging infectious diseases of the 21st century","authors":"Sijo Asokan ,&nbsp;Isiaka Ismaila Damilare ,&nbsp;Sunil Kumar ,&nbsp;Rohan Kumar Pandey ,&nbsp;Gaurav Verma ,&nbsp;Nilotpal Banerjee ,&nbsp;Guhanraj Radhamanalan ,&nbsp;Smitha Vijayan ,&nbsp;Teena Jacob ,&nbsp;Divya Rajeswary","doi":"10.1016/j.diagmicrobio.2026.117277","DOIUrl":"10.1016/j.diagmicrobio.2026.117277","url":null,"abstract":"<div><div>Emerging infectious diseases have risen significantly in the twenty-first century as ecological disruption, climate change, expanding human–animal interfaces, and global mobility intensify opportunities for pathogen transmission. This review synthesizes historical and contemporary evidence across viral, bacterial, fungal, and parasitic threats to characterize how diverse pathogens emerge and spread. Foundational events such as the 1918 influenza pandemic, mid-century influenza pandemics, the emergence of HIV/AIDS, and the eradication of smallpox provide context for understanding modern disease dynamics. In recent decades, coronaviruses including SARS, MERS, and SARS-CoV-2, pandemic H1N1, avian influenza subtypes, and major arboviruses such as dengue, chikungunya, Zika, West Nile virus, and yellow fever have demonstrated the rapidity with which zoonotic pathogens can disseminate globally. Viral hemorrhagic fevers including Ebola, Marburg, Lassa, and Crimean–Congo hemorrhagic fever remain critical threats, especially in regions with limited health-care capacity. Concurrently, antimicrobial resistance, the emergence of <em>Candida auris</em>, and the climate-driven expansion of endemic mycoses involving <em>Histoplasma, Coccidioides</em>, and <em>Blastomyces</em> highlight the increasing importance of fungal pathogens. Parasitic diseases such as artemisinin-resistant malaria, zoonotic trypanosomiasis, and expanding Leishmania transmission reflect shifting ecological conditions. These patterns are shaped by intersecting drivers including deforestation, wildlife trade, agricultural intensification, urban crowding, conflict, and rapid microbial evolution that enable spillover and sustained transmission. Although advances in genomic surveillance, metagenomic diagnostics, mRNA vaccines, monoclonal antibodies, and broad-spectrum antivirals have strengthened global response capacity, substantial gaps persist in equity, surveillance, and access to countermeasures. Strengthening One Health systems and resilient public health infrastructures is essential to anticipate and mitigate emerging infectious threats.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117277"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Achieving 24-hour reporting turnaround for clinical surveillance detection of eight carbapenemase genes using combined multiplex molecular assays","authors":"Majie C. Foster,&nbsp;Kailee Cummings,&nbsp;Mohammad Y. Khan,&nbsp;Janine Bodnar,&nbsp;Christine Jacobsen,&nbsp;Kara Miller,&nbsp;Nicola Faraci,&nbsp;Shannon Morris,&nbsp;Catharine Prussing,&nbsp;Elizabeth Nazarian,&nbsp;Kimberlee A. Musser","doi":"10.1016/j.diagmicrobio.2026.117273","DOIUrl":"10.1016/j.diagmicrobio.2026.117273","url":null,"abstract":"<div><div>Carbapenemase-producing organisms, including carbapenem-resistant Enterobacterales, <em>Acinetobacter</em> and <em>Pseudomonas</em> species, contribute to over 49,000 infections and &gt;4,000 deaths annually in the United States. The Centers for Disease Control and Prevention recommends surveillance using dual swab testing.</div><div>While a culture-first approach is routinely utilized for carbapenemase-producing organism screening, results require 3 workdays or more. In contrast, Wadsworth Center employs a molecular-first algorithm, combining the Cepheid Xpert Carba-R assay with laboratory developed test multiplex PCR. Using shared reagents for efficiency and specimen preservation, this method detects the most prevalent carbapenemase genes, <em>bla</em>_KPC, <em>bla</em>_NDM, <em>bla</em>_VIM, <em>bla</em>_OXA-48-like, and <em>bla</em>_IMP, as well as <em>Acinetobacter baumannii</em>-associated genes, <em>bla</em>_OXA-23-like, <em>bla</em>_{OXA-24/40-like}, and <em>bla</em>_OXA-58-like, and produces actionable results in less than one workday. Wadsworth Center’s rapid carbapenemase-producing organism colonization screening algorithm supports prompt healthcare protocol initiation and epidemiological response.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117273"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aspergillus fumigatus brain abscess in an immunocompromised patient receiving a second-generation Bruton Tyrosine Kinase inhibitor (BTKi)","authors":"Marios Lampros ,&nbsp;Eleni Romeo ,&nbsp;Christos Kittas ,&nbsp;Georgios Kafritsas ,&nbsp;George A. Alexiou ,&nbsp;Spyridon Voulgaris","doi":"10.1016/j.diagmicrobio.2026.117270","DOIUrl":"10.1016/j.diagmicrobio.2026.117270","url":null,"abstract":"<div><div>Chronic lymphocytic leukemia (CLL) is a frequent type of adult leukemia. Bruton Tyrosine Kinase inhibitors (BTKi) are first-line treatments for CLL. Despite being efficient, BTKi have also been associated with significant side effects, including arrhythmias, hemorrhagic complications, and opportunistic infections. Zanubrutinib is a second-generation BTKi that recently received FDA approval for CLL and is associated with improved outcomes and a better safety profile compared to first-generation BTKi. In the present study, we report a case of a patient with CLL, with an in-range absolute neutrophil count and an isolated <em>Aspergillus fumigatus</em> brain abscess mimicking a brain tumor. The lesion was excised \"en bloc\", and lesion cultures revealed <em>Aspergillus fumigatus</em> sensitive to amphotericin and voriconazole. The patient received postoperative treatment with voriconazole. While invasive fungal infections with brain involvement have been previously reported, to our knowledge, this is the first documented case of an isolated <em>Aspergillus fumigatus</em> brain abscess in a patient receiving zanubrutinib.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117270"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study of Acanthamoeba keratitis: Three-year experience with an integrated clinical and diagnostic workflow","authors":"Margherita Ortalli ,&nbsp;Antonio Moramarco ,&nbsp;Piera Versura ,&nbsp;Giovanna Liguori ,&nbsp;Giuseppe Russello ,&nbsp;Simone Ambretti ,&nbsp;Simone Baiocchi ,&nbsp;Giacomo Nigrisoli ,&nbsp;Michele Potenza ,&nbsp;Luigi Fontana ,&nbsp;Tiziana Lazzarotto","doi":"10.1016/j.diagmicrobio.2025.117247","DOIUrl":"10.1016/j.diagmicrobio.2025.117247","url":null,"abstract":"<div><div><em>Acanthamoeba</em> keratitis (AK) is a rare but sight-threatening corneal infection, caused by free-living protozoa of the genus <em>Acanthamoeba</em>. Although cases are rising in high-income countries, the nonspecific presentation and overlapping features with other keratitis frequently result in misdiagnosis of AK, with poorer outcomes and impaired quality of life. A delayed diagnosis can allow the infection to progress to deeper corneal layers, increasing the risk of severe structural damage and requiring emergency keratoplasty to preserve ocular integrity and regain vision. This retrospective study describes a three-year experience at a Northern Italy tertiary center using an integrated diagnostic workflow combining clinical evaluation, in vivo confocal microscopy, culture, and -since 2024- real-time PCR. Among 39 patients with suspected AK, 11 cases were confirmed. Culture showed 92 % sensitivity in first diagnoses but decreased to 77 % when relapses were included. PCR, introduced as a routine tool in 2024, showed 100 % sensitivity in first diagnoses and proved crucial in detecting low-burden or culture-negative relapses. Confocal microscopy reached a sensitivity and specificity of 82 %. Early targeted anti-amoebic therapy, guided by this integrated approach, contributed to favorable outcomes in most cases, limiting the need for surgical intervention. These findings support the utility of combining methods for timely and accurate diagnosis of AK. Despite ongoing challenges in the clinical management of AK, our findings reinforce the critical value of adopting molecular diagnostics to enable earlier, more accurate identification and targeted treatment.</div></div>","PeriodicalId":11329,"journal":{"name":"Diagnostic microbiology and infectious disease","volume":"114 4","pages":"Article 117247"},"PeriodicalIF":1.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145940955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}