Lancet MicrobePub Date : 2024-09-21DOI: 10.1016/j.lanmic.2024.100996
Chibuike Ibe, Carolina Henritta Pohl
{"title":"Epidemiology and drug resistance among Candida pathogens in Africa: Candida auris could now be leading the pack.","authors":"Chibuike Ibe, Carolina Henritta Pohl","doi":"10.1016/j.lanmic.2024.100996","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100996","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356160","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}
Lancet MicrobePub Date : 2024-09-19DOI: 10.1016/j.lanmic.2024.100991
Akaninyene Otu, Dimple Chudasama, Russell Hope, Dakshika Jeyaratnam
{"title":"Data for action: the crucial role of hospitals in controlling Clostridioides difficile infection in England.","authors":"Akaninyene Otu, Dimple Chudasama, Russell Hope, Dakshika Jeyaratnam","doi":"10.1016/j.lanmic.2024.100991","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100991","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298317","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}
Lancet MicrobePub Date : 2024-09-17DOI: 10.1016/j.lanmic.2024.100990
Felipe Vásquez-Ponce, Marco Vianello, Johana Becerra, Jesus G M Pariona, Karine Dantas, Gregory Melocco, Guilherme M Oliveira, Fernanda Esposito, Nilton Lincopan
{"title":"Global epidemiological trend of Klebsiella pneumoniae ST340: emergence of subclade KL15 co-producing K pneumoniae carbapenemase-2 and New Delhi metallo-β-lactamase-7 in the Americas.","authors":"Felipe Vásquez-Ponce, Marco Vianello, Johana Becerra, Jesus G M Pariona, Karine Dantas, Gregory Melocco, Guilherme M Oliveira, Fernanda Esposito, Nilton Lincopan","doi":"10.1016/j.lanmic.2024.100990","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100990","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298321","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}
Lancet MicrobePub Date : 2024-09-14DOI: 10.1016/j.lanmic.2024.100980
Christopher Fernandez-Prada, Nilmar S Moretti, Rubens L do Monte-Neto
{"title":"Critical loss: the effects of VEuPathDB defunding on global health.","authors":"Christopher Fernandez-Prada, Nilmar S Moretti, Rubens L do Monte-Neto","doi":"10.1016/j.lanmic.2024.100980","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100980","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298316","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":"The catalogue of Mycobacterium tuberculosis mutations associated with drug resistance to 12 drugs in China from a nationwide survey: a genomic analysis.","authors":"Shaojun Pei, Zexuan Song, Wei Yang, Wencong He, Xichao Ou, Bing Zhao, Ping He, Yang Zhou, Hui Xia, Shengfen Wang, Zhongwei Jia, Timothy M Walker, Yanlin Zhao","doi":"10.1016/S2666-5247(24)00131-9","DOIUrl":"https://doi.org/10.1016/S2666-5247(24)00131-9","url":null,"abstract":"<p><strong>Background: </strong>WHO issued the first edition catalogue of Mycobacterium tuberculosis complex (MTBC) mutations associated with drug resistance in 2021. However, country-specific issues might lead to arising complex and additional drug-resistant mutations. We aimed to fully reflect the characteristics of drug resistance mutations in China.</p><p><strong>Methods: </strong>We analysed MTBC isolates from the nationwide drug-resistant tuberculosis surveillance with 70 counties in 31 provinces, municipalities, and autonomous regions in China. Three types of MYCOTB plates were used to perform drug susceptibility testing for 12 antibiotics (rifampicin, isoniazid, ethambutol, levofloxacin, moxifloxacin, amikacin, kanamycin, ethionamide, clofazimine, linezolid, delamanid, and bedaquiline). Mutations were divided into five groups according to their odds ratios, positive predictive values, false discovery rate-corrected p values, and 95% CIs: (1) associated with resistance; (2) associated with resistance-interim; (3) uncertain significance; (4) not associated with resistance-interim; and (5) not associated with resistance. The Wilcoxon rank-sum and Kruskal-Wallis tests were used to quantify the association between mutations and minimum inhibitory concentrations (MICs). Our dataset was compared with the first edition of the WHO catalogue.</p><p><strong>Findings: </strong>We analysed 10 146 MTBC isolates, of which 9071 (89·4%) isolates were included in the final analysis. 744 (8·2%) isolates were resistant to rifampicin and 1339 (14·8%) to isoniazid. 208 (1·9%) of 11 065 mutations were classified as associated with resistance or associated with resistance-interim. 33 (97·1%) of 34 mutations in group 1 and 92 (52·9%) of 174 in group 2 also appeared in groups 1 or 2 of the WHO catalogue. Of 81 indel mutations in group 2, 15 (18·5%) were in the WHO catalogue. The newly discovered mutation gyrA_Ala288Asp was associated with levofloxacin resistance. MIC values for rifampicin, isoniazid, moxifloxacin, and levofloxacin corresponding to resistance mutations in group 1 were significantly different (p<0·0001), and 12 high-level resistance mutations were detected. 61 mutations in group 3 occurred as solo in at least five phenotypically susceptible isolates, but with MIC values moderately higher than other susceptible isolates. Among 945 phenotypically resistant but genotypically susceptible isolates, 433 (45·8%) were mutated for at least one efflux pump gene.</p><p><strong>Interpretation: </strong>Our analysis reflects the complexity of drug resistance mutations in China and suggests that indel mutations, efflux pump genes, protein structure, and MICs should be fully considered in the WHO catalogue, especially in countries with a high tuberculosis burden.</p><p><strong>Funding: </strong>National Key Research and Development Program of China and the Science and Technology Major Project of Tibetan Autonomous Region of China.</p>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366902","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}
Lancet MicrobePub Date : 2024-09-13DOI: 10.1016/j.lanmic.2024.100995
Elena Dalla Vecchia
{"title":"Pathoplexus: towards fair and transparent sequence sharing.","authors":"Elena Dalla Vecchia","doi":"10.1016/j.lanmic.2024.100995","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.100995","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298322","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}
Lancet MicrobePub Date : 2024-09-12DOI: 10.1016/S2666-5247(24)00151-4
Malavika Nair, Lucy Gettins, Matthew Fuller, Shona Kirtley, Joris Hemelaar
{"title":"Global and regional genetic diversity of HIV-1 in 2010-21: systematic review and analysis of prevalence.","authors":"Malavika Nair, Lucy Gettins, Matthew Fuller, Shona Kirtley, Joris Hemelaar","doi":"10.1016/S2666-5247(24)00151-4","DOIUrl":"https://doi.org/10.1016/S2666-5247(24)00151-4","url":null,"abstract":"<p><strong>Background: </strong>The extensive global genetic diversity of HIV-1 poses a major challenge to HIV vaccine development. We aimed to determine recent estimates of and changes in the global and regional distributions of HIV-1 genetic variants.</p><p><strong>Methods: </strong>We conducted a systematic literature review by searching PubMed, Embase, Global Health, and CINAHL for studies containing country-specific HIV-1 subtyping data, published between Jan 1, 2010 and Sep 16, 2022. The proportions of HIV-1 subtypes, circulating recombinant forms (CRFs), and unique recombinant forms (URFs) in each country were weighted by UNAIDS estimates of the numbers of people living with HIV (PLHIV) in each country to obtain regional and global prevalence estimates of HIV-1 subtypes, CRFs, and URFs with 95% CIs for the time periods 2010-15 and 2016-21. The protocol is registered with PROSPERO, CRD42017067164.</p><p><strong>Findings: </strong>We obtained 1044 datasets, containing HIV-1 subtyping data from 653 013 PLHIV from 122 countries in 2010-2021. In 2016-2021, subtype C accounted for 50·4% (95% CI 50·2-50·7; n=18 570 462 of 36 823 798) of global HIV infections, subtype A for 12·4% (12·2-12·6; n=4 571 250), subtype B for 11·3% (11·1-11·5; n=4 157 686), subtype G for 2·9% (2·9-3·0; n=1 083 568), subtype D for 2·6% (2·5-2·7; n=945 815), subtype F for 0·9% (0·8-0·9; n=316 724), CRFs for 15·1% (14·9-15·3; n=5 564 566), and URFs for 2·0% (1·9-2·1; n=733 374). Subtypes H, J, and K each accounted for 0·1% or less of infections. Compared with 2010-15, we observed significant (p<0·0001) increases in global proportions of subtype A (0·9%, 95% CI 0·7 to 1·1) and subtype C (3·4%, 3·0 to 3·7) and decreases in subtype D (-0·5%, -0·6 to -0·4), subtype G (-0·8%, -1·0 to -0·7), CRFs (-1·0%, -1·3 to -0·8), and URFs (-1·8%, -1·9 to -1·7), with no changes for subtypes B and F. The global proportion of infections attributed to recombinants decreased from 21·6% (95% CI 21·4 to 21·7; n=7 099 252 of 32 622 808) in 2010-15 to 19·3% (19·1 to 19·5; n=7 094 694 of 36 823 798) in 2016-21 (-2·3%, 95% CI -2·6 to -2·0; p<0·0001). Regional distributions of HIV-1 variants were complex and evolving, with global trends in the prevalence of HIV-1 variants supported by trends across the regions.</p><p><strong>Interpretation: </strong>Global and regional HIV-1 genetic diversity are complex and continue to evolve. Continued and improved surveillance of HIV-1 variants remains vital for HIV vaccine development and implementation.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298320","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":"Detection of dengue virus and chikungunya virus in wastewater in Portugal: an exploratory surveillance study.","authors":"Sílvia Monteiro, Raquel Pimenta, Filipa Nunes, Mónica V Cunha, Ricardo Santos","doi":"10.1016/S2666-5247(24)00150-2","DOIUrl":"https://doi.org/10.1016/S2666-5247(24)00150-2","url":null,"abstract":"<p><strong>Background: </strong>The global distribution and prevalence of arboviral diseases have increased in recent years, driven by factors such as climate change, biodiversity loss, globalisation, and urbanisation. These diseases are often underestimated due to uneven surveillance and unreported asymptomatic cases. Current surveillance relies on vector and clinical surveillance. In this study, we aimed to explore wastewater-based surveillance (WBS) as an additional tool for dengue virus (DENV) and chikungunya virus (CHIKV) tracking.</p><p><strong>Methods: </strong>In this exploratory surveillance study, WBS was done at eleven wastewater treatment plants in three regions in Portugal (North, Lisboa and Vale do Tejo, and south). Using quantitative RT-PCR, we quantified in raw wastewater the RNA concentrations of DENV and CHIKV (non-structural viral protein 1 [nsP1] and envelope protein [E1] genes) once every 2 weeks for a period of 11 months, between May 16, 2022, and April 19, 2023. Results were normalised with crAssphage (concentration of target viral RNA divided by the concentration of crAssphage DNA) and provided as median normalised viral load. Prevalence (proportion of positive samples) and viral quantities were summarised for the total sampling period, by calendar month, and by seasons.</p><p><strong>Findings: </strong>273 samples were collected from 11 wastewater treatment plants situated across the North (n=75 samples), Lisboa and Vale do Tejo (n=98), and south (n=100) regions of Portugal. DENV was detected in 68 (25%) of 273 samples, with a median viral load of 1·1 × 10<sup>-4</sup> (IQR 3·2 × 10<sup>-5</sup> to 8·0 × 10<sup>-4</sup>). CHIKV was detected in 30 (11%) of 273 samples, with median viral loads of 3·1 × 10<sup>-4</sup> (1·6 × 10<sup>-4</sup> to 6·4 × 10<sup>-4</sup>; nsP1 gene) and 7·8 × 10<sup>-4</sup> (4·2 × 10<sup>-4</sup> to 2·0 × 10<sup>-</sup>³; E1 gene). The pattern of occurrence of CHIKV was similar between regions whereas slight differences were found for DENV. When combining results for the three studied regions, DENV prevalence and viral load had two seasonal peaks (summer and winter) and CHIKV prevalence and viral load had a single peak during March and April of 2023.</p><p><strong>Interpretation: </strong>This study highlights the potential of WBS as a potent tool for gauging the epidemiological landscape of DENV and CHIKV in Portugal, where autochthonous cases have not yet been detected. WBS could serve as an additional element to conventional surveillance approaches, especially in areas where real-time clinical surveillance data are scarce or delayed.</p><p><strong>Funding: </strong>EU Emergency Support Instrument and Fundação para a Ciencia e Tecnologia.</p>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298318","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}
Lancet MicrobePub Date : 2024-09-12DOI: 10.1016/j.lanmic.2024.07.010
Charlotte S Ho, Carlos T H Wong, Thet Tun Aung, Rajamani Lakshminarayanan, Jodhbir S Mehta, Saaeha Rauz, Alan McNally, Balint Kintses, Sharon J Peacock, Cesar de la Fuente-Nunez, Robert E W Hancock, Darren S J Ting
{"title":"Antimicrobial resistance: a concise update.","authors":"Charlotte S Ho, Carlos T H Wong, Thet Tun Aung, Rajamani Lakshminarayanan, Jodhbir S Mehta, Saaeha Rauz, Alan McNally, Balint Kintses, Sharon J Peacock, Cesar de la Fuente-Nunez, Robert E W Hancock, Darren S J Ting","doi":"10.1016/j.lanmic.2024.07.010","DOIUrl":"https://doi.org/10.1016/j.lanmic.2024.07.010","url":null,"abstract":"<p><p>Antimicrobial resistance (AMR) is a serious threat to global public health, with approximately 5 million deaths associated with bacterial AMR in 2019. Tackling AMR requires a multifaceted and cohesive approach that ranges from increased understanding of mechanisms and drivers at the individual and population levels, AMR surveillance, antimicrobial stewardship, improved infection prevention and control measures, and strengthened global policies and funding to development of novel antimicrobial therapeutic strategies. In this rapidly advancing field, this Review provides a concise update on AMR, encompassing epidemiology, evolution, underlying mechanisms (primarily those related to last-line or newer generation of antibiotics), infection prevention and control measures, access to antibiotics, antimicrobial stewardship, AMR surveillance, and emerging non-antibiotic therapeutic approaches. The Review also discusses the potential roles of artificial intelligence in addressing AMR, including antimicrobial susceptibility testing, AMR surveillance, antimicrobial stewardship, diagnosis, and antimicrobial drug discovery and development. This Review highlights the urgent need for addressing the global effects of AMR and for rapid advancement of relevant technology in this dynamic field.</p>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":null,"pages":null},"PeriodicalIF":20.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298395","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}