Journal of Clinical Microbiology最新文献

{"title":"Establishment of epidemiological cutoff values for <i>Fonsecaea pedrosoi</i>, the primary etiologic agent of chromoblastomycosis, and eight antifungal medications.","authors":"Dallas J Smith, Marcia S C Melhem, Jessy Dirven, Conceição Maria Pedrozo E Silva de Azevedo, Sirlei Garcia Marques, Bruna Jacomel Favoreto de Souza Lima, Vania Aparecida Vicente, Maria da Glória Teixeira Sousa, James Venturini, Nathan P Wiederhold, Amir Seyedmousavitasieh, Philippe J Dufresne, Sybren de Hoog, Shawn R Lockhart, Ferry Hagen, Daniel Wagner de C L Santos","doi":"10.1128/jcm.01903-24","DOIUrl":"https://doi.org/10.1128/jcm.01903-24","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Chromoblastomycosis, a fungal neglected tropical disease, is acquired through traumatic inoculation and is clinically characterized by a chronic granulomatous infection of the skin and subcutaneous tissue. &lt;i&gt;Fonsecaea pedrosoi&lt;/i&gt; is the most commonly reported etiologic agent globally. Itraconazole is considered first-line therapy, but successful treatment with terbinafine, voriconazole, and posaconazole has been reported. &lt;i&gt;F. pedrosoi&lt;/i&gt; minimum inhibitory concentration (MIC) data are limited, and epidemiological cutoffs (ECVs) are lacking; such data are important to help monitor antifungal resistance trends and guide initial antifungal selection. Thus, we performed antifungal susceptibility testing (AFST) on &lt;i&gt;F. pedrosoi&lt;/i&gt; isolates and determined the MIC distributions and ECVs. AFST on &lt;i&gt;Fonsecaea pedrosoi&lt;/i&gt; isolates was conducted at six laboratories from October 2023 to June 2024. Species identification was previously confirmed by DNA sequence analysis. AFST was performed by CLSI M38 standard broth microdilution method for itraconazole, voriconazole, posaconazole, isavuconazole, ketoconazole, terbinafine, flucytosine, and amphotericin B. The ECVs were established using the iterative statistical method with ECOFFinder (version 2.1) following CLSI M57 guidelines. We analyzed MIC results from 148 &lt;i&gt;Fonsecaea pedrosoi&lt;/i&gt; isolates. The calculated ECVs were itraconazole, 0.5 µg/mL; voriconazole, 0.5 µg/mL; posaconazole, 0.5 µg/mL; isavuconazole, 1 µg/mL; ketoconazole, bimodal, no ECV determined; terbinafine, 0.25 µg/mL; flucytosine, rejected; and amphotericin, 8 µg/mL. These &lt;i&gt;Fonsecaea pedrosoi&lt;/i&gt; ECVs, obtained through a multicenter international effort, provide a baseline to better understand the &lt;i&gt;in vitro&lt;/i&gt; antifungal susceptibility profile of this species and monitor resistance. Clinicians and researchers can use these values to detect non-wild-type isolates with reduced susceptibility, reevaluate therapeutic options, and investigate potential clinical resistance if treatment failure occurs.IMPORTANCEChromoblastomycosis is a neglected tropical disease caused by an environmental, dematiaceous fungus. This fungal disease is acquired after a break in the skin that allows the fungus to enter, leading to a chronic infection in the skin and subcutaneous tissue. It is difficult to treat and often requires years of antifungal treatment. &lt;i&gt;Fonsecaea pedrosoi&lt;/i&gt; is the most reported causative agent globally. Limited antifungal susceptibility data exist for &lt;i&gt;F. pedrosoi&lt;/i&gt; making interpreting minimum inhibitory concentration (MIC) results difficult. We performed antifungal susceptibility testing on 148 &lt;i&gt;F&lt;/i&gt;. &lt;i&gt;pedrosoi&lt;/i&gt; isolates to establish MIC distributions and epidemiologic cutoff values (ECVs) for eight antifungals, including those commonly used to treat chromoblastomycosis. The calculated ECVs for the commonly used antifungals itraconazole and terbinafine were 0.5 and 0.25 µg/mL, respectively. ECVs can be helpful","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0190324"},"PeriodicalIF":6.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of real-time PCR assays for human papillomavirus using urine samples: a systematic review and meta-analysis.","authors":"Byeong-Min Park, Soohyun Kim, Jieun Choi, Yoonkyung Song, Seungman Park","doi":"10.1128/jcm.01352-24","DOIUrl":"https://doi.org/10.1128/jcm.01352-24","url":null,"abstract":"<p><p>This study aims to assess the diagnostic accuracy of real-time PCR assays for detecting human papillomavirus (HPV) in urine samples through a systematic review and meta-analysis. A comprehensive search of PubMed, Embase, and Springer databases (2014-2024) was conducted. Studies comparing urine-based HPV tests with cervical samples as the reference standard were included. Diagnostic accuracy measures such as sensitivity, specificity, diagnostic odds ratio (DOR), likelihood ratios (LR+ and LR-), percent agreement, and Cohen's kappa were calculated. Heterogeneity was assessed using the Higgins' I² index, and subgroup analyses were performed based on HPV test type and urine volume. The study revealed that 15 studies met the inclusion criteria, with pooled sensitivity of urine-based HPV tests at 0.82 (95% CI, 0.78-0.86), specificity at 0.91 (95% CI, 0.87-0.94), positive LR at 9.5 (95% CI, 6.3-14.3), negative LR at 0.19 (95% CI, 0.16-0.24), DOR at 49 (95% CI, 32-75), and the area under the curve at 0.92 (95% CI, 0.90-0.94), with significant heterogeneity observed (I² >50%), particularly in sensitivity and specificity, and subgroup analysis indicating that urine volumes ≤20 mL demonstrated higher sensitivity compared to those >20 mL, despite this finding being based on a limited number of studies. Results suggest that urine-based HPV testing shows strong diagnostic accuracy and could be a viable alternative to cervical swabs, with potential benefits for increasing screening accessibility, especially in areas with limited healthcare resources, despite some variability and limitations in the data.IMPORTANCEThis study is significant as it thoroughly evaluates the diagnostic accuracy of real-time PCR assays for human papillomavirus (HPV) detection in urine samples through a rigorous systematic review and meta-analysis. By integrating data from multiple databases and comparing urine-based HPV tests with the established cervical sample reference standard, the study provides valuable insights into the effectiveness and reliability of non-invasive HPV screening methods. The findings demonstrate that urine-based tests exhibit high sensitivity and specificity, offering a promising alternative to traditional cervical swabs. This advancement has significant implications for increasing accessibility to HPV screening, particularly in under-resourced settings, thereby potentially enhancing cervical cancer prevention efforts on a broader scale. The study not only fills a critical gap in HPV screening methodologies but also supports the development of more inclusive and practical public health strategies for combating cervical cancer.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0135224"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of the performance of a novel diagnostic test for <i>Clostridioides difficile</i> toxins A and B using latent class analysis.","authors":"Jeremy Li, Nandini Dendukuri, Yves Longtin, Alice Banz, Charles Frenette, Philippe Gervais, Mark A Miller, Anne-Marie Bourgault, Noah L Dawang, Vivian G Loo","doi":"10.1128/jcm.01807-24","DOIUrl":"https://doi.org/10.1128/jcm.01807-24","url":null,"abstract":"<p><p>The diagnosis of <i>Clostridioides difficile</i> infection (CDI) remains challenging. Nucleic acid amplification tests (NAAT) targeting the <i>C. difficile</i> (CD) toxin B gene suffer from suboptimal specificity for CDI due to CD asymptomatic colonization. Enzyme immunoassays (EIAs) that detect the presence of CD toxins are more specific for CDI but suffer from low sensitivity. To address this challenge, assays detecting CD toxins were developed using single-molecule array (SIMOA) technology, which have much lower limits of toxin detection than conventional EIAs. In this study, stool specimens from 708 symptomatic patients were aliquoted for testing by cell cytotoxicity neutralization assay (CCNA), toxigenic culture, NAAT, conventional CD toxin EIA, and SIMOA CD toxin EIAs. Using latent class analysis, we calculated the sensitivity and specificity of each of these diagnostic tests for detecting, separately, the presence of CD bacterium, CD toxin gene, and CD toxin. We estimated that the prevalence of CDI in our cohort was 14% (95% credible interval [CI]: 0.11-0.17). While the specificity of NAAT for detecting the presence of CD toxin was 95% (95% CI: 0.94-0.97), its positive predictive value was poor due to the low prevalence of CDI. The specificity of the conventional CD toxin EIA for CDI was excellent, but the sensitivity was only 48% (95% CI: 0.41-0.55). In comparison, the sensitivities of the SIMOA toxins A and B EIAs were 76% (95% CI: 0.67-0.84) and 77% (95% CI: 0.67-0.84), respectively, while maintaining excellent specificity. We conclude that SIMOA CD toxin EIAs are significantly more sensitive than conventional CD toxin EIAs.</p><p><strong>Importance: </strong><i>Clostridioides difficile</i> infection (CDI) is the most important infectious cause of hospital-associated diarrhea worldwide, but its diagnosis remains challenging. Nucleic acid amplification tests (NAATs) targeting the <i>C. difficile</i> (CD) toxin B gene have suboptimal specificity due to the presence of CD asymptomatic colonization, while enzyme immunoassays (EIAs) that detect the toxin itself are much more specific but are limited by low sensitivity. New assays for detecting CD toxins were developed using single-molecule array (SIMOA) technology, which have much lower limits of toxin detection than conventional EIAs, potentially improving the sensitivity of these conventional EIAs while remaining highly specific. In this study, we use latent class analysis to evaluate the sensitivity and specificity of different diagnostic tests for CD, including the novel SIMOA toxin assays, in detecting the different CD targets: the presence of CD bacterium, the presence of CD toxin gene, and the presence of CD toxin.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0180724"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reaffirming DEI as a central value of JCM.","authors":"Romney M Humphries, Alexander J McAdam","doi":"10.1128/jcm.00372-25","DOIUrl":"https://doi.org/10.1128/jcm.00372-25","url":null,"abstract":"","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0037225"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and characteristics of mutations promoting occult HBV infection by ultrasensitive HBsAg assay.","authors":"Shi Song, Qian Su, Ying Yan, Huimin Ji, Huizhen Sun, Kaihao Feng, Abudulimutailipu Nuermaimaiti, Shana Halemubieke, Ling Mei, Xinru Liu, Zhuoqun Lu, Le Chang, Lunan Wang","doi":"10.1128/jcm.02071-24","DOIUrl":"https://doi.org/10.1128/jcm.02071-24","url":null,"abstract":"<p><p>The significance of occult hepatitis B virus (HBV) infection (OBI) has been increasingly recognized while the underlying mechanisms remain incompletely understood. This study aimed to identify high-frequency OBI-related mutations in HBV surface antigen (HBsAg)-negative samples tested by the ultrasensitive Lumipulse G HBsAg-Quant assay. OBI samples were collected from 32 blood establishments across 14 provinces in China. Lumipulse G HBsAg-Quant assay was performed for the re-testing and reclassification of OBI. Mutations in genotypes B (GTB) and C (GTC) were analyzed to identify high-frequency single and combined mutations. Additionally, the efficacy of commercial reagents commonly employed in clinical diagnostics for detecting mutant HBsAg was evaluated. Western Blot was used for the confirmation of extracellular HBsAg as well as the detection of intracellular HBsAg. Hydrophilicity analysis and transmembrane distribution prediction of HBsAg were utilized for further validation. Single mutations at 17 sites and 9 combined mutations in GTB indicated a significantly elevated mutation frequency. In GTC, there were single mutations at 16 sites and 9 combined mutations. Several commercial reagents commonly demonstrated limited capacity toward mutant HBsAg with T123A/P, K141C, and P142R/I/K/L (GTB) and S114A/P (GTC). The findings indicated that mutations including T123A/C/K/S, S132G/Y, P142L/R/S/T, T143M, D144G, G145A, K160R+V168A, I4T+V168A, M103I+K122R, and M103I+Q181R (GTB), along with Q101H, M103I, R160K+C221Y (GTC), were associated with reduced levels of HBsAg both extracellularly and intracellularly. Additionally, K160R (GTB) and E2G (GTC) were associated with intracellular aggregation. This study elucidates the mutations associated with decreased extracellular HBsAg with ultrasensitive HBsAg assay, providing insight for further investigation into the mechanisms of OBI.</p><p><strong>Importance: </strong>The sensitivity of HBsAg detection reagents directly impacts the identification of occult hepatitis B virus (HBV) infection (OBI). This study aims to identify high-frequency OBI-related mutations in HBV surface antigen (HBsAg)-negative samples evaluated using a Fujirebio-Lumipulse ultrasensitive HBsAg assay and to investigate the implications of these mutations on the antigenicity of HBsAg, the detection capacities of various HBsAg assays, and the effects on intracellular and extracellular levels of HBsAg. Generally, our study offers a new perspective on OBI-related mutations by ultrasensitive HBsAg assay and lays the groundwork for further research on the OBI mechanism and the enhancement of HBsAg detection reagents.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0207124"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-center evaluation of the Selux next-generation phenotyping system for gram-negative direct-from-positive blood culture antimicrobial susceptibility testing.","authors":"Vincent Streva, Joseph Gajewski, Jacqueline Pento, Alamelu Chandrasekaran, Matt Green, Jill Lindley, Micahel Huband, Asmae El Ganbour, Kristen Roberts, Kelly Flentie, Jingzi Sherman, Eric Stern, Gregory J Berry","doi":"10.1128/jcm.01819-24","DOIUrl":"https://doi.org/10.1128/jcm.01819-24","url":null,"abstract":"<p><p>Accurate and rapid antimicrobial susceptibility test (AST) results from positive blood cultures are crucial for patient care and combatting antimicrobial resistance. Although recent advancements in rapid direct-from-positive blood culture (PBC) identification platforms have enabled the provision of species-level identification and some resistance marker information within hours after blood culture positivity, AST results required for clinical decision-making often require 48 h after blood culture positivity. This study evaluated the Selux next-generation phenotyping system, including an automated PBC Separator and the Selux AST system in a multicenter clinical trial for their ability to perform AST directly from PBCs for gram-negative bacilli. The PBC separator produces McFarland equivalent inocula from positive blood cultures within 1 h, facilitating direct processing on the Selux AST system. The study evaluated 162 fresh clinical PBC samples, 307 seeded clinical samples, and 87 seeded challenge samples across 4 sites for each of the 17 antimicrobials included in the panel. The results demonstrate that the Selux system's clinical performance, reproducibility, and analytical performances are consistent when using positive blood cultures held for up to 16 h after positivity on the BACTEC and BacT/ALERT 3D and BacT/ALERT VIRTUO blood culture systems, including all major BACTEC and BacT/ALERT blood culture bottle types. These findings suggest that the PBC Separator with the Selux AST system is a valuable addition to the arsenal of tools available for rapid sepsis diagnosis and management.IMPORTANCETechnologies that consistently and substantially shorten the time between blood bottle positivity, organism identification, and complete AST results are crucial for ensuring that antimicrobial therapy can be tailored. The Selux PBC Separator and the Selux AST system perform rapid AST directly from positive blood culture bottles. This substantially shortens the gap between obtaining a positive blood bottle and organism identification and the availability of a fully actionable AST result.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0181924"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of packed red blood cells versus fresh whole human blood on the growth of nutritionally variant streptococci and <i>Streptococcus anginosus</i> group during verification of the BACT/ALERT VIRTUO blood culture system.","authors":"Heather Glassman, Jasmine Ahmed-Bentley, Rebecca Buckman, Mark Carbungco, Colleen Fletcher, Kim Sy, Joyce Wong, Charlene Porter, Claudine Desruisseaux, Valery Lavergne, Suefay Liu, Anthony Lieu, Marthe K Charles","doi":"10.1128/jcm.01987-24","DOIUrl":"https://doi.org/10.1128/jcm.01987-24","url":null,"abstract":"","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0198724"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of the diagnosis of intestinal protozoa using a multiplex qPCR strategy compared to classical microscopy: a prospective study on 3,500 stool samples over 3 years.","authors":"Florence Robert-Gangneux, Xavier Duval, Clément Cazala, Sorya Belaz, Anne Dupuis, Hélène Guegan, Brice Autier, Jean-Pierre Gangneux","doi":"10.1128/jcm.01610-24","DOIUrl":"https://doi.org/10.1128/jcm.01610-24","url":null,"abstract":"<p><p>Commercial multiplex real-time PCR (qPCR assays) are now widely used for the diagnosis of intestinal protozoan infections, but few prospective studies evaluated their performances on large patient cohorts. We extracted data from our information system from 1 January 2021 to 15 March 2024 and included all stool samples analyzed in routine. Parasites were searched using a multiplex PCR (AllPlex Gastrointestinal Panel assay, Seegene) and microscopic examination with two concentration methods. Acid-fast staining was performed when <i>Cryptosporidium</i> detection was specifically requested. In total, 3,495 stools were analyzed from 2,127 patients. <i>Giardia intestinalis</i>, <i>Cryptosporidium</i> spp., <i>Entamoeba histolytica</i>, <i>Dientamoeba fragilis,</i> and <i>Blastocystis</i> spp. were found by multiplex qPCR in 45 (1.28%), 30 (0.85%), 9 (0.25%), 310 (8.86%), and 673 (19.25%) samples, respectively, alone or in combination (<i>n</i> = 909). In the vast majority of cases, PCR detected a protozoan on the first stool sample. Microscopy was positive for <i>G. intestinalis</i>, <i>Cryptosporidium</i> spp., <i>Entamoeba histolytica/dispar</i>, <i>D. fragilis,</i> and <i>Blastocystis</i> spp. in 25 (0.7%), 8 (0.23%), 24 (0.68%), 22 (0.63%), and 229 (6.55%), samples, respectively, alone or in combination (<i>n</i> = 286 samples). No samples were PCR-/Microscopy+ for <i>G</i>. <i>intestinalis</i>, <i>Cryptosporidium</i> spp., and <i>E. histolytica</i>, while <i>D. fragilis</i> and <i>Blastocystis</i> spp. were detected only with microscopy in 6 and 20 samples, respectively. Microscopy allowed the detection of parasites not targeted by the multiplex panel (5 <i>Cystoisospora belli,</i> 331 samples with non-pathogenic protozoa, and 68 samples with helminths). Overall, the multiplex PCR proved more efficient to detect protozoan parasites, but a microscopic technique should be performed when infection with <i>C. belli</i> (HIV-infected patients) or helminths is suspected (migrants and travelers).IMPORTANCEIn the era of increasing use of multiplex PCR panels for the diagnosis of intestinal protozoan infections, it is important to form an opinion on the positioning of those assays within a lab workflow. This study analyzes routine results obtained prospectively by microscopy and a commercial multiplex PCR over 3 years, and shows that the assay meets the expectations of a clinical laboratory for the detection of protozoan parasites of medical interest. It is recalled that <i>Cystoisospora belli</i> is not targeted by the multiplex assay, and that microscopy still remains necessary to detect helminths.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0161024"},"PeriodicalIF":6.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings of the Clinical Microbiology Open 2024: artificial intelligence applications in clinical microbiology.","authors":"Jennifer Dien Bard, Andrea M Prinzi, Paige M K Larkin, David R Peaper, Daniel D Rhoads","doi":"10.1128/jcm.01804-24","DOIUrl":"https://doi.org/10.1128/jcm.01804-24","url":null,"abstract":"<p><p>The Clinical Microbiology Open (CMO) is a meeting sponsored by the American Society for Microbiology (ASM) in collaboration with its Corporate Council and Clinical and Public Health Microbiology representatives, which is held to discuss topics that are relevant to both industry and practicing clinical microbiologists. The 2024 CMO was held in Oceanside, California on February 1 and 2. Participants included clinical and public health laboratory directors, representatives from government agencies, and biotechnology industry partners. The group engaged in discussions with the theme, \"The Lab of the Future.\" One of the primary topics discussed was artificial intelligence (AI) opportunities in clinical microbiology laboratories. This report summarizes the discussion and sentiment of the group regarding AI tools, opportunities and challenges of AI in clinical laboratories, and potential future directions for AI in clinical microbiology practice.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0180424"},"PeriodicalIF":6.1,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid prediction of carbapenemases in <i>Pseudomonas aeruginosa</i> by imipenem/relebactam and MALDI-TOF MS.","authors":"Ana Candela, María Fernández-Billón, Pablo Aja-Macaya, Lucía González-Pinto, Pablo Arturo Fraile-Ribot, Esther Viedma, Isaac Alonso-García, Tania Blanco-Martín, Roberto Estévez-Alfaya, Ana Fernández-González, Alejandro Beceiro, Carla López-Causapé, Marina Oviaño, Germán Bou, Antonio Oliver, Jorge Arca-Suárez","doi":"10.1128/jcm.01105-24","DOIUrl":"https://doi.org/10.1128/jcm.01105-24","url":null,"abstract":"<p><p><i>Pseudomonas aeruginosa</i> is a major nosocomial pathogen commonly involved in multidrug-resistant (MDR) infections that are very difficult to treat. Imipenem/relebactam is a new carbapenem/β-lactamase inhibitor combination with robust activity against <i>P. aeruginosa</i>. However, resistance is increasingly reported, and rapid detection is, therefore, crucial so that appropriate treatments can be prescribed. We have developed a rapid MALDI TOF-MS-based method that can accurately predict the presence of carbapenemases in <i>P. aeruginosa</i> using imipenem/relebactam. The method was developed using a retrospective and a prospective collection of 419 <i>P</i>. <i>aeruginosa</i> isolates (including recombinant isolates and WGS-characterized clinical strains) encompassing the most important β-lactam resistance mechanisms. The MALDI TOF-MS method is based on the detection of the hydrolysis of imipenem in the presence or absence of relebactam, measuring modifications in the mass spectra of imipenem after incubation with bacteria. The method was evaluated against a retrospective collection and then validated against 250 prospectively collected clinical isolates, showing a 98% (246/250) agreement between the phenotype and the MALDI-TOF MS hydrolysis result and a 100% accordance with the β-lactam resistance genotype. Some errors in detecting GES-producing isolates and in detecting different mutational resistance mechanisms associated with imipenem/relebactam resistance (MICs ranging from 4 to 8 mg/L) were observed. All results were obtained within 1 hour, positioning the MALDI-TOF-based test as a rapid and easy-to-perform method for detection of carbapenemases (except GES enzymes) in <i>P. aeruginosa</i>. Besides, implementation of the method in routine laboratory screening would facilitate the correct use of imipenem/relebactam to treat <i>P. aeruginosa</i> infections.IMPORTANCEWhile several rapid diagnostic methods have been developed for the detection of ESBLs and carbapenemases to improve treatment decision-making in Enterobacterales, there is a lack of approaches to rapidly identify resistance mechanisms and predict β-lactam susceptibility in <i>Pseudomonas aeruginosa</i>. Taking advantage of the mechanism of action and the high efficacy of the newly developed β-lactam/β-lactamase inhibitor combination imipenem/relebactam against <i>P. aeruginosa</i>, we developed a WGS-guided, MALDI-TOF-based algorithm that accurately predicts the presence of carbapenemase enzymes in this bacterium and aids in forecasting the imipenem/relebactam susceptibility profile. The implementation of this method in routine laboratory testing would provide significant support in the rapid decision-making for the use of imipenem/relebactam in severe <i>P. aeruginosa</i> infections.</p>","PeriodicalId":15511,"journal":{"name":"Journal of Clinical Microbiology","volume":" ","pages":"e0110524"},"PeriodicalIF":6.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}