Infectious Disease Reports最新文献

{"title":"Subspecies Identification and Characterization of Drug Resistance and Virulence Factors in Clinical Strains of <i>Mycobacterium abscessus</i> Complex Isolated from South India.","authors":"Kumaran Oudhaya, Ellappan Kalaiarasan, Anoop Alex, Kooleri Padinjare Veetil Hyma, Harishni Padmanaban, Sangitha Jayagandan, Noyal Mariya Joseph","doi":"10.3390/idr18040073","DOIUrl":"10.3390/idr18040073","url":null,"abstract":"<p><strong>Background: </strong><i>Mycobacterium abscessus</i> complex (MABC), comprising <i>Mycobacterium abscessus</i> subsp. <i>abscessus</i> (MABa), <i>Mycobacterium abscessus</i> subsp. <i>bolletii</i> (MABb), and <i>Mycobacterium abscessus</i> subsp. <i>massiliense</i> (MABm), is an emerging group of non-tuberculous mycobacteria with clinically significant infections and challenging treatment outcomes due to extensive antimicrobial resistance. Accurate subspecies identification and characterization of resistance- and virulence-associated determinants are essential for effective disease management. This study aimed to determine the prevalence and subspecies distribution of MABC and to characterize resistance-associated mutations and virulence factors, including biofilm formation.</p><p><strong>Methods: </strong>A total of 1110 NTM-suspected clinical samples were screened during the study period, between January 2024 and October 2025. Samples negative by GeneXpert MTB/RIF were subjected to Mycobacteria Growth Indicator Tube (MGIT) culture, followed by Ziehl-Neelsen staining and MPT64 antigen testing. Acid-fast bacilli-positive, MPT64-negative isolates were identified as NTM and analyzed using GenoType CM and NTM-DR line probe assays (LPA) for species identification and detection of resistance-associated mutations. A polymerase chain reaction (PCR) assay was optimized to differentiate MABa and MABm. All MABC clinical strains were further characterized for colony morphology (smooth and rough) and biofilm formation. Three biofilm-producing MABa strains (2 rough and 1 smooth) that were detected as macrolide-resistant by NTM-DR were subjected to whole-genome sequencing (WGS).</p><p><strong>Results: </strong>Among 1110 clinical samples, MABC was identified in 2.25% (<i>n</i> = 25) of cases, while other NTM species accounted for 4.41% (<i>n</i> = 49). Among 25 MABC clinical strains, 14 (56%) were MABm, and 11 (44%) were MABa, as confirmed by both LPA and PCR. LPA-NTM DR detected <i>erm(41)</i> T28 sequevar (<i>n</i> = 9) and C28 mutation (<i>n</i> = 2) among MABa strains, with one strain exhibiting aminoglycoside resistance-associated <i>rrs</i> mutation. Nineteen isolates displayed a smooth morphotype (MABa = 8 and MABm = 11), and six were rough (MABa = 3 and MABm = 3). Biofilm formation was observed in both smooth (<i>n</i> = 5) and rough (<i>n</i> = 4) morphotypes. WGS analysis confirmed <i>erm(41)</i> T28 sequevar, identified a missense mutation (A238G), and revealed genes associated with glycopeptidolipid biosynthesis.</p><p><strong>Conclusions: </strong>Our findings provide important insights into subspecies identification and genetic determinants associated with drug resistance and virulence in MABC. The biofilm-forming ability observed in both smooth and rough morphotypes emphasizes its potential role in persistence and treatment challenges, emphasizing the need for comprehensive diagnostic strategies.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza Virus Isolation for Public Health Surveillance Before, During, and After the COVID-19 Pandemic: Experiences from the New York State National Influenza Reference Center Laboratory.","authors":"Amruta Pramod Moghe, Emaly Starrett Leak, Jennifer May Laplante, Kirsten St George","doi":"10.3390/idr18040071","DOIUrl":"10.3390/idr18040071","url":null,"abstract":"<p><strong>Background: </strong>Influenza viruses can cause mild to severe illnesses. The burden of disease varies widely depending on multiple factors, including the type and subtype of circulating viruses, timing of the season, flu vaccine efficacy and vaccination rates. Influenza viruses are also highly prone to genetic change and rapid spread due to modern human movement patterns, making influenza surveillance vital for public health awareness, guidance, policy, disease mitigation, and annual recommendations on vaccine composition.</p><p><strong>Methods: </strong>A network of three National Influenza Reference Centers (NIRCs) was established in the United States more than 10 years ago to support the Centers for Disease Control and Prevention's (CDC) Influenza Division with its national influenza surveillance efforts. Located in California, New York, and Wisconsin, they are funded by CDC via a collaborative agreement with the Association of Public Health Laboratories (APHL). The role of the NIRCs is critical to national and global influenza surveillance, providing rapid information on circulating influenza strains from three arms of laboratory testing: (1) the virus isolation project (VIP), (2) next-generation sequencing (NGS), and (3) anti-viral drug resistance testing.</p><p><strong>Results: </strong>Here, we review the data generated in the VIP lab of the New York State (NYS) NIRC before, during, and after the COVID-19 pandemic and discuss its utility in an understanding of disease dynamics and viral evolution, as well as public health policy and decision making during this historic period in health care.</p><p><strong>Conclusion: </strong>Continued preparedness and surveillance are critical to mitigating the impact of evolving influenza viruses.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Resistance as a Global Public Health Challenge: Epidemiological Burden, Bioethical Dimensions and Emerging Therapeutic Strategies.","authors":"Christos Ntais, Ioanna P Chatziprodromidou","doi":"10.3390/idr18040070","DOIUrl":"10.3390/idr18040070","url":null,"abstract":"<p><strong>Background/objectives: </strong>Antimicrobial resistance (AMR) is a major global public health threat, compromising prevention and treatment of infectious diseases. This narrative review examines AMR as a multifactorial and transnational crisis through epidemiological, One Health, social and bioethical perspectives, and discusses emerging non-antibiotic preventive and therapeutic strategies.</p><p><strong>Methods: </strong>PubMed and Scopus were searched using terms related to AMR, epidemiology, public health, surveillance, One Health, bioethics, equity and alternative therapies. Peer-reviewed medical and public health articles were considered, together with selected reports from international organizations and public health agencies.</p><p><strong>Results: </strong>AMR is driven by inappropriate antibiotic use in human medicine, livestock, aquaculture and agriculture, combined with weaknesses in infection prevention, stewardship, environmental control and surveillance. Epidemiological evidence shows a substantial global burden, marked regional inequalities in resistance patterns, surveillance capacity and policy response, and major consequences, including increased mortality, prolonged hospitalization, rising healthcare costs and disproportionate effects on vulnerable populations. Key bioethical concerns include collective responsibility, equitable access to effective treatment, stewardship, global justice and intergenerational accountability. Emerging non-antibiotic strategies vary in translational maturity: vaccines and selected microbiome-based interventions have preventive or supportive roles in defined settings, bacteriophage therapy is used mainly in compassionate or specialized contexts, and many antimicrobial peptides and nanotechnology-based platforms remain experimental or early translational.</p><p><strong>Conclusions: </strong>AMR requires coordinated global action grounded in One Health, strong public health systems, integrated surveillance, responsible antimicrobial use and sustained innovation. Effective containment must also address social inequalities, ethical stewardship, equitable access to diagnostics and treatment, and responsibility toward future generations.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infection-Associated Pediatric Acute-Onset Neuropsychiatric Syndrome: A Review of Immunological Mechanisms, Clinical Phenotypes, and Therapeutic Strategies.","authors":"Enoch Chi Ngai Lim, Nga Chong Lisa Cheng, Chi Eung Danforn Lim","doi":"10.3390/idr18040069","DOIUrl":"10.3390/idr18040069","url":null,"abstract":"<p><strong>Background/objectives: </strong>Pediatric acute-onset neuropsychiatric syndrome (PANS) describes the rapid onset of obsessive-compulsive symptoms or severe food restriction, accompanied by neuropsychiatric or somatic features that are not better explained by another disorder. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) is a related, more narrowly defined construct in which symptoms are temporally associated with group A <i>Streptococcus</i> infection. This review examines clinical symptoms, infectious associations, proposed immune mechanisms, biomarker limitations, and treatment strategies for infection-associated PANS/PANDAS.</p><p><strong>Methods: </strong>A structured narrative search of PubMed/MEDLINE, Embase, the Cochrane Library, Google Scholar/publisher-indexed literature, ClinicalTrials.gov, and reference lists was performed up to 16 June 2026. Original cohorts, case series, systematic reviews, narrative reviews, consensus guidance, mechanistic studies, and registered prospective studies were prioritized. The review was not designed as a PRISMA-ScR scoping review; however, the methods were expanded to improve transparency and align with SANRA principles.</p><p><strong>Results: </strong>Group A <i>Streptococcus</i> remains the best characterized infectious association, although prospective studies have not uniformly demonstrated a consistent temporal relationship between streptococcal infection and neuropsychiatric exacerbations. Parent-reported surveys and case-based literature also describe temporal associations with <i>Mycoplasma pneumoniae</i>, influenza-like illnesses, upper respiratory infections, <i>Borrelia burgdorferi</i>, Epstein-Barr virus, and SARS-CoV-2. Proposed mechanisms include molecular mimicry, anti-D1R and anti-D2R antibodies, other antineuronal antibodies, calcium/calmodulin-dependent protein kinase II signaling, blood-brain barrier vulnerability, cytokine and Th17 effects, neuroinflammatory amplification, basal ganglia/CSTC circuit dysfunction, and gut-oral-brain immune interactions. None currently provides a definitive diagnostic biomarker.</p><p><strong>Conclusions: </strong>Infection-associated PANS is best approached as a clinically defined, heterogeneous neuroimmune presentation that requires rigorous differential diagnosis, multidisciplinary care, cautious treatment escalation, prospective biomarker validation, and large, multicenter treatment trials.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Spinal Epidural Abscess and Paraplegia After Group A Streptococcal Pharyngitis.","authors":"Blake J McKinley, Rob M Seby, Robert C Chase, Tatjana Gavrancic, Jeremy Collado, Libardo Rueda Prada","doi":"10.3390/idr18040068","DOIUrl":"10.3390/idr18040068","url":null,"abstract":"<p><p><b>Background</b>: Spinal epidural abscesses (SEA) are rare, occurring 2.5-3 times per 10,000 hospital admissions. While streptococcus species comprise 7% of reported SEAs, Group A Streptococcus (GAS) has been described only once in the medical literature to our knowledge. <b>Case presentation</b>: We present a case of GAS pharyngitis with subsequent paraplegia from a GAS SEA. A 33-year-old female presented to the emergency department (ED) and was initially diagnosed with GAS pharyngitis and a suspected strained lower back. Following treatment with amoxicillin, she returned with worsened back pain, radiculopathy, and leukocytosis, for which she was treated with cyclobenzaprine. On her third presentation, she had new bilateral lower extremity weakness with decreased sensation, bilateral ankle clonus, and hyperreflexia. MRI of the thoracic and lumbar spine revealed a multiloculated SEA at T5-T10 requiring laminectomy and abscess evacuation. Intraoperative cultures grew <i>Streptococcus pyogenes</i>. Despite surgery, medical management, and physical therapy, she remained paraplegic. <b>Conclusions</b>: To our knowledge, this is the first report of SEA preceded by GAS pharyngitis. This case exposes the critical association between a recent infection, progression of back pain, eventual neurologic symptoms, and inflammatory markers that should trigger concern for SEA and early evaluation with MRI.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Clostridioides difficile</i> Infection (CDI) Disease Burden (Cases, Hospitalizations, and Deaths) in China: A Systematic Literature Review.","authors":"Frederick J Angulo, Genming Zhao, Yuan Wu, Zundong Yin, Jin Yang, Shahnaz Khan, Daniel Khuong Tran, Elisa N Gonzalez, Anli Sun, Steven Shen, Jamie Findlow","doi":"10.3390/idr18040067","DOIUrl":"10.3390/idr18040067","url":null,"abstract":"<p><strong>Background/objectives: </strong>Although <i>Clostridioides difficile</i> infection (CDI) is a key cause of global morbidity and mortality, the burden of CDI in mainland China is not well-defined. The objective of this systematic literature review was to summarize the available epidemiologic evidence on the CDI disease burden (cases, hospitalizations, and deaths) in mainland China.</p><p><strong>Methods: </strong>Six databases (three global [PubMed, Embase, Cochrane] and three Chinese [Chinese National Knowledge Infrastructure, Chinese Science Citation, Wanfang]) were searched on 5 August 2025 using CDI-related and epidemiological search terms. No date or language limits were applied. Real-world epidemiologic studies of adults and/or children with laboratory-confirmed CDI in mainland China reporting population-based CDI incidence, hospital-based CDI incidence, and/or CDI admission rates were included. All studies not meeting these criteria were excluded. Risk-of-bias (RoB) assessment was performed using the Newcastle-Ottawa Scale. Results were summarized descriptively.</p><p><strong>Results: </strong>In total, 11 articles formed the evidence base for this review; each was a single-center, hospital-based study conducted in one of six cities in mainland China and published between 2014 and 2023. RoB assessment indicated that the evidence base was appropriate for this study. No study reported population-based CDI incidence. In total, 10 studies reported hospital-based CDI incidence (0 to 82.0/10,000 patient-days), and four reported CDI admission rates (0 to 23.1/1000 admissions). Eight studies reported mortality rates, which varied across studies.</p><p><strong>Conclusions: </strong>Several single-center, hospital-based studies demonstrate that CDI is present in hospitals in mainland China, but there are no published population-based CDI incidence estimates. These results should be interpreted considering this study's limitations, including potential publication and selection bias, heterogeneity, and limited generalizability. Overall, the burden of CDI is poorly understood in mainland China. Thus, prospective epidemiological studies, including those with sensitive detection methods, are needed to examine CDI burden across multiple cities in mainland China. These efforts would help illuminate the CDI burden and guide prevention efforts. (PROSPERO ID 1140152; registered 17 March 2026; funding by Pfizer Inc.).</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multitarget Therapeutic Strategies for Chagas Disease: Natural Compounds, Antimicrobial Peptides, and Cell-Based Immunomodulation.","authors":"Ana María Fernández-Presas, Katia Jarquín-Yáñez, Adolfo Cruz-Reséndiz, Oscar Rodríguez-Lima, Jaime Zamora-Chimal, Blanca Esther Blancas-Luciano","doi":"10.3390/idr18040065","DOIUrl":"10.3390/idr18040065","url":null,"abstract":"<p><p>Chagas disease, caused by <i>Trypanosoma cruzi</i>, remains a major public health problem in Latin America and an emerging global health concern due to population mobility. Although benznidazole and nifurtimox remain the only approved antiparasitic drugs, their limited efficacy in chronic infection, prolonged treatment regimens, frequent adverse effects, and variable activity across parasite strains highlight the need for new therapeutic strategies. In addition, the pathogenesis of chronic Chagas disease is driven not only by parasite persistence but also by immune-mediated tissue damage, particularly in chronic Chagas cardiomyopathy. In this review, we examine emerging therapeutic approaches that extend beyond conventional trypanocidal chemotherapy, with emphasis on natural products, antimicrobial peptides, and cell-based immunomodulatory strategies. Plant compounds and essential oils have shown antiparasitic activity through mechanisms including oxidative stress induction, membrane disruption, interference with sterol biosynthesis, and mitochondrial dysfunction, while some extracts also modulate host immune responses. Antimicrobial peptides display dual potential by directly damaging parasite membranes and organelles or by reshaping infection-associated inflammatory responses. In parallel, cell-based therapies such as mesenchymal stromal cells, tolerogenic dendritic cells, and bone marrow-derived cells have demonstrated promising cardioprotective and immunoregulatory effects in experimental chronic Chagas disease. Collectively, these approaches support a multitarget therapeutic framework in which parasite-directed and host-directed interventions may complement each other. Further mechanistic studies, standardization, and translational validation will be essential to advance these candidates toward clinically useful therapies for Chagas disease.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytomegalovirus Retinitis in Newly Diagnosed Advanced HIV Infection: A Three-Case Series Emphasizing Multidisciplinary Infection Screening.","authors":"Shintaro Yataka, Kinya Tsubota, Kei Wakatsuki, Risa Sugawara, Masaki Asakage, Yoshihiko Usui","doi":"10.3390/idr18040066","DOIUrl":"10.3390/idr18040066","url":null,"abstract":"<p><strong>Background/objectives: </strong>Cytomegalovirus (CMV) retinitis remains a significant opportunistic infection in patients with advanced human immunodeficiency virus (HIV) infection, particularly with late HIV diagnoses. This three-case series aimed to describe HIV-associated CMV retinitis in newly diagnosed advanced HIV infection with documented concurrent and/or prior infectious conditions, and to highlight the importance of bord systemic screening and multidisciplinary management.</p><p><strong>Methods: </strong>We retrospectively reviewed three male patients diagnosed with HIV-associated CMV retinitis at a tertiary ophthalmology referral center. Clinical findings, CD4-positive T-cell counts, HIV-RNA levels, aqueous humor CMV-DNA results, systemic infectious conditions, treatment and ocular outcomes were summarized.</p><p><strong>Results: </strong>All patients had marked cellular immunodeficiency, with CD4-positive T-cell counts ranging from 46 to 141 cells/µL, and CMV-DNA was detected in aqueous humor in all cases. The infectious burden was substantial: all three patients had syphilis and hepatitis B virus infection, two had oral candidiasis, and individual patients had chlamydia infection, tuberculosis, amebic colitis, or a history of herpes zoster. One patient was initially suspected of having syphilitic uveitis, which illustrates how coinfections may obscure the diagnosis of CMV retinitis. Retinal detachment occurred in two cases and was surgically repaired with anatomical recovery.</p><p><strong>Conclusions: </strong>These cases emphasize that CMV retinitis in newly diagnosed advanced HIV infection should prompt broad infection screening and multidisciplinary evaluation, particularly in the setting of delayed HIV diagnosis and severe immunosuppression. Comprehensive screening for opportunistic and sexually transmitted infections, prompt ocular virological confirmation, and multidisciplinary management are essential in patients with HIV-associated CMV retinitis.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Brain Microabscesses and a Lung Abscess Caused by <i>Streptococcus intermedius</i> Following COVID-19: A Case Report and Literature Review.","authors":"Ryoma Takeda, Kazunori Yamada, Takenori Abe, Tomoyuki Ishigo, Hirohiko Nakamura","doi":"10.3390/idr18040064","DOIUrl":"10.3390/idr18040064","url":null,"abstract":"<p><strong>Background: </strong>Secondary bacterial infections are increasingly recognized after coronavirus disease 2019 (COVID-19); however, bacterial abscess formation remains uncommon, and the simultaneous occurrence of brain and lung abscesses has not been previously reported. We report a rare case of <i>Streptococcus intermedius</i> infection presenting with multiple brain microabscesses and a lung abscess following COVID-19.</p><p><strong>Case presentation: </strong>A 75-year-old man with no significant medical history except cholelithiasis experienced persistent fever following a diagnosis of COVID-19 and subsequently developed impaired consciousness 17 days later. Because bacterial meningitis was suspected, he was admitted to a neurology-specialized hospital on the same day. Brain MRI revealed more than 80 small enhancing lesions scattered throughout the brain parenchyma, consistent with multiple microabscesses. Chest CT demonstrated a mass-like lesion in the left lower lobe. Although cerebrospinal fluid cultures were negative, blood cultures obtained on admission yielded <i>S. intermedius</i>. Further investigation of the source of infection revealed moderate periodontitis, suggesting the oral cavity as the probable portal of entry. The patient was treated with intravenous antibiotics for eight weeks based on antimicrobial susceptibility testing, resulting in near-complete resolution of the lesions.</p><p><strong>Conclusions: </strong>Although a causal relationship between COVID-19 and abscess formation cannot be established, COVID-19-associated immune and mucosal barrier dysfunction may have contributed to the progression and dissemination of infection in this patient. Clinicians should be aware of the possibility of severe bacterial superinfection when fever or respiratory symptoms related to COVID-19 persist, even in patients without overt immunocompromise, particularly in those with pre-existing oral infections.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Virulence Gene <i>papGII</i> a Predictor of Urosepsis in Uropathogenic <i>E. coli</i>?","authors":"Nihitta Hanna, Suji Thangamani, Rosemol Varghese, Jiji Smila Arockiasamy, Balaji Veeraraghavan, Rani Diana Sahni","doi":"10.3390/idr18040063","DOIUrl":"10.3390/idr18040063","url":null,"abstract":"<p><strong>Background: </strong>Urosepsis is a life-threatening condition accounting for approximately 20-30% of all sepsis cases and typically arises from ascending infection by uropathogenic <i>Escherichia coli</i> (UPEC). Disease progression is mediated by virulence factors, including adhesins, iron acquisition systems, and toxins. Among these, P fimbriae, particularly <i>papGII</i> adhesin subunit, have been implicated in the transition from uncomplicated urinary tract infection (UTI) to severe urosepsis. This study aimed to evaluate whether <i>papGII</i> carriage, alone or in combination with other UPEC virulence determinants and clinical risk factors, can predict urosepsis.</p><p><strong>Methods: </strong>A total of 60 paired <i>Escherichia coli</i> isolates from concurrent blood and urine samples of adults with clinical sepsis were collected between January and June 2024. Control isolates were obtained from patients with cystitis (n = 28) and pyelonephritis (n = 32). Polymerase chain reaction (PCR) assays were used to detect fifteen virulence-associated genes, including the <i>pap</i> operon (with <i>papG</i> allelic variants), the type 1 fimbriae (<i>fimH)</i>, S fimbriae (<i>sfaS</i>), curli fimbriae (<i>csgA</i>), <i>afa/Dr</i> adhesin operon genes, cytotoxic necrotizing factor 1 (<i>cnf1</i>), and the aerobactin biosynthesis (<i>iucD</i>) and receptor (<i>iutA</i>) genes. Associations between gene carriage and clinical groups were analyzed using chi-square tests.</p><p><strong>Results: </strong>The incidence of urosepsis increased with age, peaking in the 60-69-year age group. Renal disease and catheterization were identified as significant risk factors (<i>p</i> < 0.05). More than 95% of UPEC isolates carried the <i>csgA</i> gene associated with biofilm formation and the <i>iucD</i> gene. The α- hemolysin toxin (<i>hlyA</i>) was significantly associated with urosepsis [X²(1, N = 120) = 6.62, <i>p</i> = 0.03]. No significant differences were observed in the carriage of <i>papA</i>, <i>papC</i>, or <i>fimH</i>. Although <i>papGII</i> was present in 65% of urosepsis-associated UPEC isolates, it did not demonstrate a statistically significant independent association with urosepsis [<i>p</i> = 0.1].</p><p><strong>Conclusion: </strong>This study demonstrates that while <i>papGII</i> may contribute to the pathogenic potential of UPEC and facilitate systemic infection, it is not a reliable independent predictor of urosepsis.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 4","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}