Lancet Microbe最新文献

{"title":"Effect of weekly fever-screening and treatment and monthly RDT testing and treatment on the infectious reservoir of malaria parasites in Burkina Faso: a cluster-randomised trial","authors":"","doi":"10.1016/S2666-5247(24)00114-9","DOIUrl":"10.1016/S2666-5247(24)00114-9","url":null,"abstract":"<div><h3>Background</h3><p>The majority of <em>Plasmodium</em> spp infections in endemic countries are asymptomatic and a source of onward transmission to mosquitoes. We aimed to examine whether <em>Plasmodium falciparum</em> transmission and malaria burden could be reduced by improving early detection and treatment of infections with active screening approaches.</p></div><div><h3>Methods</h3><p>In this 18-month cluster randomised study in Sapone, Burkina Faso, households were enrolled and randomly assigned (1:1:1) to one of three groups: group 1 (control) received standard of care only, group 2 received active weekly, at home, fever screening by a community health worker regardless of symptoms, participants with a fever received a rapid diagnostic test (RDT) and treatment if RDT positive, and group 3 received active weekly fever screening (as in group 2) plus a monthly RDT regardless of symptoms, and treatment if RDT positive. Eligible households had a minimum of three eligible residents, one in each age group (&lt;5 years, 5–15 years, and &gt;15 years). The primary outcome was parasite prevalence by quantitative PCR (qPCR) in the end-of-study cross-sectional survey. Secondary outcomes included parasite and gametocyte prevalence and density in all three end-of-season cross-sectional surveys, incidence of infection, and the transmissibility of infections to mosquitoes. This trial was registered at ClinicalTrials.gov (<span><span>NCT03705624</span><svg><path></path></svg></span>) and is completed.</p></div><div><h3>Findings</h3><p>A total of 906 individuals from 181 households were enrolled during two phases, and participated in the study. 412 individuals were enrolled between Aug 9 and 17, 2018, and participated in phase 1 and 494 individuals were enrolled between Jan 10 and 31, 2019, in phase 2. In the end-of-study cross-sectional survey (conducted between Jan 13 and 21, 2020), <em>P</em> <em>falciparum</em> prevalence by qPCR was significantly lower in group 3 (29·26%; 79 of 270), but not in group 2 (45·66%; 121 of 265), when compared with group 1 (48·72%; 133 of 273; risk ratio 0·65 [95% CI 0·52–0·81]; p=0·0001). Total parasite and gametocyte prevalence and density were also significantly lower in group 3 in all surveys. The largest differences were seen at the end of the dry season, with gametocyte prevalence 78·4% and predicted transmission potential 98·2% lower in group 3 than in group 1.</p></div><div><h3>Interpretation</h3><p>Active monthly RDT testing and treatment can reduce parasite carriage and the infectious reservoir of <em>P</em> <em>falciparum</em> to less than 2% when used during the dry season. This insight might inform approaches for malaria control and elimination.</p></div><div><h3>Funding</h3><p>Bill &amp; Melinda Gates Foundation, European Research Council, and The Netherlands Organization for Scientific Research.</p></div>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666524724001149/pdfft?md5=3625f4e912596580c8926b56ecf0a1f1&pid=1-s2.0-S2666524724001149-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Host and pathogen factors that influence variability of Mycobacterium tuberculosis lipid body content in sputum from patients with tuberculosis: an observational study","authors":"","doi":"10.1016/S2666-5247(24)00108-3","DOIUrl":"10.1016/S2666-5247(24)00108-3","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;High proportions of &lt;em&gt;Mycobacterium tuberculosis&lt;/em&gt; cells in sputum containing triacylglycerol-rich lipid bodies have been shown to be associated with treatment failure or relapse following antituberculous chemotherapy. Although lipid body determination is a potential biomarker for supporting clinical trial and treatment decisions, factors influencing variability in sputum frequencies of lipid body-positive (%LB&lt;sup&gt;+&lt;/sup&gt;) &lt;em&gt;M tuberculosis&lt;/em&gt; in patients are unknown. We aimed to test our hypothesis that exposure to host-generated NO and &lt;em&gt;M tuberculosis&lt;/em&gt; strains are factors associated with differences in sputum %LB&lt;sup&gt;+&lt;/sup&gt;.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this observational study, we determined %LB&lt;sup&gt;+&lt;/sup&gt; frequencies before treatment by microscopy in patients with smear-positive tuberculosis from two separate prospective observational study settings (Gondar, Ethiopia, recruited between May 1, 2010, and April 30, 2011, and Fajara, The Gambia, who provided sputum samples before treatment between May 5, 2010, and Dec 22, 2011). In Ethiopia, fractional exhaled nitric oxide (FeNO) was measured as a biomarker of host NO, and &lt;em&gt;M tuberculosis&lt;/em&gt; strain differences were determined by spoligotyping. Treatment response was assessed by percentage weight change after 7 months. In The Gambia, treatment responses were assessed as change in BMI and radiographic burden of disease after 6 months. Sputum &lt;em&gt;M tuberculosis&lt;/em&gt; isolates were studied in vitro for their %LB&lt;sup&gt;+&lt;/sup&gt; and triacylglycerol synthase 1 (&lt;em&gt;tgs1&lt;/em&gt;) mRNA responses to NO exposure. Propidium iodide staining was used as a measure of NO strain toxicity. Correlation between in vitro %LB&lt;sup&gt;+&lt;/sup&gt; frequencies following NO exposure and those of the same strain in sputum was examined with linear regression and Dunnett’s multiple comparison test.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;In Ethiopia, 73 patients who were smear positive for pulmonary tuberculosis were recruited (43 [59%] were male and 30 [41%] were female). Of these, the %LB&lt;sup&gt;+&lt;/sup&gt; in the sputum of 59 patients showed linear correlation with log&lt;sub&gt;10&lt;/sub&gt; FeNO (&lt;em&gt;r&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=0·28; p&lt;0·0001) and an association with strain spoligotype was suggested. Seven &lt;em&gt;M tuberculosis&lt;/em&gt; strains from The Gambia showed different dose-responses to NO in vitro, demonstrated by changing lipid body content, &lt;em&gt;tgs1&lt;/em&gt; transcription, and bacterial toxicity. In sputum %LB&lt;sup&gt;+&lt;/sup&gt; frequencies correlated with in vitro %LB&lt;sup&gt;+&lt;/sup&gt; responses to NO of the corresponding isolate. In a subset of 34 patients across both cohorts, higher sputum %LB&lt;sup&gt;+&lt;/sup&gt; frequencies before treatment were associated with weaker responses to treatment than lower sputum %LB&lt;sup&gt;+&lt;/sup&gt; frequencies.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;&lt;em&gt;M tuberculosis&lt;/em&gt; strain and exposure to host-generated NO are associated with sputum %LB&lt;sup&gt;+&lt;/sup&gt;. Our results support the use of &lt;em&gt;M tuber","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666524724001083/pdfft?md5=7d78eae280e8ecf4a664a6d473d8f268&pid=1-s2.0-S2666524724001083-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 detection and genomic surveillance: moving to ensure accessible tools in low-income and middle-income countries","authors":"","doi":"10.1016/S2666-5247(24)00128-9","DOIUrl":"10.1016/S2666-5247(24)00128-9","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666524724001289/pdfft?md5=ad803718819acd245fa5d6c45e9c40f8&pid=1-s2.0-S2666524724001289-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global wastewater surveillance for pathogens with pandemic potential: opportunities and challenges.","authors":"Nicholas C Grassly, Alexander G Shaw, Michael Owusu","doi":"10.1016/j.lanmic.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.07.002","url":null,"abstract":"<p><p>Wastewater surveillance holds great promise as a sensitive method to detect spillover of zoonotic infections and early pandemic emergence, thereby informing risk mitigation and public health response. Known viruses with pandemic potential are shed in human stool or urine, or both, and the experiences with SARS-CoV-2, monkeypox virus, and Zika virus highlight the feasibility of community-based wastewater surveillance for pandemic viruses that have different transmission routes. We reviewed human shedding and wastewater surveillance data for prototype viruses representing viral families of concern to estimate the likely sensitivity of wastewater surveillance compared with that of clinical surveillance. We examined how data on wastewater surveillance detection, together with viral genetic sequences and animal faecal biomarkers, could be used to identify spillover infections or early human transmission and adaptation. The opportunities and challenges associated with global wastewater surveillance for the prevention of pandemics are described in this Personal View, focusing on low-income and middle-income countries, where the risk of pandemic emergence is the highest. We propose a research and public health agenda to ensure an equitable and sustainable solution to these challenges.</p>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endemicity and diversification of Morganella spp and carbapenemase-producing Morganella spp.","authors":"Xi Li, Jiayao Yao, Longjie Zhou, Hua Zhou, Jintao He","doi":"10.1016/j.lanmic.2024.100970","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100970","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tackling antimicrobial resistance: recognising the proposed five blind spots can accelerate progress.","authors":"Madhukar Pai, Sumanth Gandra, Poshan Thapa, Sergio Carmona","doi":"10.1016/j.lanmic.2024.100968","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100968","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical distribution of the Cryptococcus gattii species complex: a systematic review.","authors":"Victoria Poplin, Clarissa Smith, Diego H Caceres, Patricia F Herkert, Olujimi Jegede, George R Thompson, John W Baddley, Ilan S Schwartz, Ryan Kubat, Mark A Deka, Mitsuru Toda, Shawn R Lockhart, Tom Chiller, Ferry Hagen, Nathan C Bahr","doi":"10.1016/S2666-5247(24)00161-7","DOIUrl":"https://doi.org/10.1016/S2666-5247(24)00161-7","url":null,"abstract":"<p><p>The taxonomy of the Cryptococcus gattii species complex continues to evolve, and has been divided into five pathogenic species. The objective of this systematic review was to summarise the geographical distribution of the C gattii species complex and the species within the C gattii species complex. We searched PubMed for articles related to human, animal, ecological, or laboratory-based studies of C gattii species complex isolates with traceable geographical origin published from January, 1970, until September, 2021. Having extracted their geographical origin, we used ArcMap to construct maps according to the highest degree of resolution allowed by their reported taxonomy, to reflect the most likely area of transmission on the basis of published reports of human isolates. 604 such articles were included in the study. This review indicated that although C gattii species complex isolates have been reported globally, understanding their heterogeneous geographical distribution by species can have implications for researchers and clinicians in formulating research questions and considering diagnostic quandaries.</p>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of extensively drug-resistant Pseudomonas aeruginosa ST308 co-producing Klebsiella pneumoniae carbapenemase and New Delhi metallo-β-lactamase in Viet Nam.","authors":"Dennis Nurjadi, Truong Nhat My, Lisa Göpel, Sébastien Boutin, Le Huu Song, Thirumalaisamy P Velavan","doi":"10.1016/j.lanmic.2024.100958","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100958","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique factors to consider when exploring the surge in reported pertussis cases in China.","authors":"Qian-Qian Du, Ya-Hong Hu, Qing-Hong Meng, Dan Yu, Kai-Hu Yao","doi":"10.1016/j.lanmic.2024.100959","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100959","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of mpox immunity among the core group and its potential to prevent future large-scale outbreaks.","authors":"Lao-Tzu Allan-Blitz, Jeffrey D Klausner","doi":"10.1016/j.lanmic.2024.100957","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100957","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}