American Journal of Tropical Medicine and Hygiene最新文献

{"title":"Prevalence and Antimicrobial-Resistant Campylobacter jejuni and Campylobacter coli in Free-Range Chickens in Northwest Ethiopia.","authors":"Mesfin Worku, Belay Tessema, Getachew Ferede, Linnet Ochieng, Shubisa Abera Leliso, Florence Mutua, Arshnee Moodley, Baye Gelaw, Delia Grace","doi":"10.4269/ajtmh.24-0578","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0578","url":null,"abstract":"<p><p>Campylobacter enteritis is the most common bacterial foodborne disease in humans. Long-term use of antibiotics in chicken production may result in antimicrobial resistance in Campylobacter strains. Information on the antimicrobial resistance profile of Campylobacter species among free-range chickens in Ethiopia is scarce. Hence, this study aimed to determine the prevalence and antimicrobial resistance of Campylobacter jejuni and Campylobacter coli among free-range chickens in Amhara National Regional state, northwest Ethiopia from November 1, 2022 to April 30, 2023. Cloacal swabs were collected from free-range backyard chickens, directly inoculated onto modified charcoal cefoperazone deoxycholate agar, and incubated at reduced O2 concentration at 42°C for 48 hours. Suspected colonies were confirmed at the species level using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. The associated factors were analyzed using the Fisher exact test. A P <0.05 at 95% CI was considered statistically significant. Among the 286 cloacal samples, 15.0% (n = 43/286; CI: 10.2-19.5) were positive for Campylobacter species. C. jejuni (60.5%) was more frequent than C. coli (39.5%). Of the total isolates, 62.8% (n = 27/43), 51.2% (n = 22/43), and 16.3% (n = 7/43) of the Campylobacter species were resistant to tetracycline, ciprofloxacin, and erythromycin, respectively. Of the total Campylobacter species isolates, 9.3% (n = 4/43) were multidrug resistant. Campylobacter species resistance to tetracycline and ciprofloxacin was high in general among backyard chickens. Multidrug-resistant Campylobacter species were also identified, and they require special attention to prevent the potential dissemination of the strains to humans in the community.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reemergence of Human Rabies in an Endemic Peruvian Amazon Region.","authors":"César Sánchez-Álvarez, Alfredo Chiappe-Gonzalez, Cristhian Resurrección Delgado, Joshua Paz-Majluf, Rotciv Arteaga-Vega, Manuel López-Fuentes, Juan José Montenegro-Idrogo","doi":"10.4269/ajtmh.25-0032","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0032","url":null,"abstract":"<p><p>We report the case of two girls from a rural community in the Peruvian Amazon who were exposed to the rabies virus, with fatal outcomes in both cases. The reemergence of rabies in this endemic area after more than 11 years of successful control through massive immunization policies is highlighted in this report. In these cases, exposure occurred through contact with a domestic cat, although bat bites remain the most common source of rabies transmission in the region. Adopting a One Health approach and reinforcing periodic mass immunization campaigns are essential to prevent further outbreaks in endemic rabies zones.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human T Cell Lymphotropic Virus Type 1 and Human T Cell Lymphotropic Virus Type 2 Mortality in the Shipibo-Konibo People.","authors":"Isaac E Alva, Magaly M Blas, Nicanor Mori, Victor Sal Y Rosas, Alex de la Cruz, Joseph R Zunt, Eduardo Gotuzzo","doi":"10.4269/ajtmh.25-0082","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0082","url":null,"abstract":"<p><p>High rates of human T cell lymphotropic virus type 1 (HTLV-1) and human T cell lymphotropic virus type 2 (HTLV-2) infections have been reported among Andean and Amazonian Peruvian indigenous populations in Peru. The Shipibo-Konibo people are the third-largest Amazonian indigenous group living in Peru. By using data from two observational studies conducted in the Shipibo-Konibo community, we estimated that the risk of all-cause death at 12 years was 3.11 times higher (95% CI: 1.58-6.10) for people with HTLV-1 infection compared with those with HTLV-2 infection or without HTLV-1 and HTLV-2 infections.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Park Size and Trail Environment Influence the Seasonal Transmission Risk of Tick-Borne Pathogens in Nashville Metropolitan Area Parks, Tennessee.","authors":"Brent C Newman, Rachel N Wofford, Athena Lemon, Abelardo C Moncayo","doi":"10.4269/ajtmh.24-0413","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0413","url":null,"abstract":"<p><p>We identified tick and tick-borne pathogen presence across 24 Nashville Metropolitan Area parks and evaluated factors that influence their occurrence. Parks were categorized by size (small, medium, large, and extra-large; n = 6 per group) and drag sampled during spring, summer, and fall from June 2020 to June 2021. Drag transects were equally distributed between trails and forested areas. A total of 25,081 ticks were collected, with Amblyomma americanum (A. americanum) constituting 99.5% of collections, followed by Dermacentor variabilis (D. variabilis), Amblyomma maculatum (A. maculatum), and Ixodes scapularis (I. scapularis). Adult and nymphal ticks were screened for pathogens, which consisted of seven bacterial and two viral species. In A. americanum (n = 375 pools), we identified Ehrlichia chaffeensis in 15 pools, as well as Ehrlichia ewingii and Panola Mountain Ehrlichia in 14 pools. In A. maculatum (n = 8 pools), we identified Rickettsia parkeri in three pools. Amblyomma americanum and D. variabilis adult and nymph collections were highest in the summer, A. maculatum collection was highest in the spring, and I. scapularis collection was highest in the fall. Large parks supported the highest aggregate tick densities across all life stages-adults (0.42 ticks/100 m2), nymphs (1.33 ticks/100 m2), and larvae (111.42 ticks/100 m2). Additionally, nymph abundance was significantly greater in forested areas (14.3 ± 3.01) compared with trails (3.98 ± 0.56) across all park size categories. Our findings indicate that seasonal patterns in tick abundance are influenced by park size and that the maintenance of well-defined trails can help to mitigate the risk of exposure to ticks and their associated pathogens during peak activity seasons in urban park environments.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefit of Empiric Antiviral Treatment for Patients with Influenza-Associated Pneumonia Admitted to the Intensive Care Unit: A Retrospective Cohort Study.","authors":"Ya-Tang Pai, Yu-Kai Huang, Chia-Ping Su, Ching-Tai Huang","doi":"10.4269/ajtmh.24-0503","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0503","url":null,"abstract":"<p><p>Influenza remains a clinically significant viral cause of community-acquired pneumonia in adults. Without timely antiviral treatment, severe influenza complicated by pneumonia may lead to poorer outcomes. However, the effect of empiric antiviral treatment on serious or life-threatening influenza is not well documented from clinical trials. We performed a retrospective study of patients with severe influenza complicated by pneumonia as confirmed by bronchoalveolar lavage polymerase chain reaction (PCR) in intensive care units at a tertiary hospital in Taiwan from 2009 to 2019. We collected demographic and clinical data from medical records. We compared survival outcomes between those with or without empiric antiviral treatment (before or after PCR diagnosis) with the Cox proportional hazard model. Of the 77 patients enrolled in this study, the survival rates were higher among those treated empirically with antivirals before diagnostic test results were obtained than for those who were not (P = 0.024). Compared with the nonempiric treatment group, the empiric antiviral treatment group had a 68.3% lower risk of death. Meanwhile, the risk of death increased by 3.8% for each unit increase of acute physiology and chronic health evaluation (APACHE) III score. Empiric antiviral treatment of influenza may lead to a better survival rate. For patients with suspected severe influenza, antiviral medication should be initiated as soon as possible without waiting for laboratory confirmation of influenza virus infection.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of the Tigecycline Resistance-Mediating tet(Y) Gene in Acinetobacter baumannii Isolates from Intensive Care Unit Patients in Pakistan.","authors":"Zainab Tufail, Kokab Jabeen, Mahnoor Chaudhry, Sana Mustafa, Sidrah Saleem, Afshan Zia, Fareeha Imran, Waleed Tariq, Muhammad Junaid Tahir, Muhammad Sohaib Asghar","doi":"10.4269/ajtmh.24-0295","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0295","url":null,"abstract":"<p><p>Acinetobacter baumannii (A. baumannii) is a Gram-negative, nonfermenting bacterium implicated as a major cause of opportunistic infections in healthcare settings because it is a multidrug-resistant organism. Tigecycline was developed to circumvent the prevalent mechanism of A. baumannii resistance against tetracycline. This study aims to determine the frequency of tigecycline resistance and to characterize the tigecycline-resistant tet(Y), tet(X), and tet(A) genes in A. baumannii clinical isolates. A descriptive cross-sectional study was conducted at Lahore General Hospital (LGH), Lahore, Pakistan, from February 2023 to February 2024. A total of 195 A. baumannii samples were isolated from various samples collected from patients admitted to the intensive care unit of LGH over a period of 1 year. The antimicrobial susceptibility of A. baumannii was assessed using the Kirby-Bauer disc diffusion assay, and the results were reported according to the Clinical and Laboratory Standards Institute 2022 guidelines. The activity of tigecycline was reported according to the British Society for Antimicrobial Chemotherapy 2021 guidelines. The detection of tigecycline resistance genes tet(Y), tet(X), and tet(A) was performed using polymerase chain reaction, and the amplified products were confirmed using Sanger sequencing. Acinetobacter baumannii were resistant to multiple antibiotics. Minocycline was the most effective antibiotic, with 10.8% resistance, whereas cefotaxime was the least effective, with 74.4% resistance in 195 isolates of A. baumannii. Resistance to tigecycline was detected in 9% of isolates of A. baumannii. The tet(A) gene was the most frequently found gene, present in 20% of the tigecycline-resistant isolates, followed by tet(X) and tet(Y) genes in 18% and 9% of isolates, respectively. A high frequency of plasmid-mediated tigecycline resistance was detected in A. baumannii samples, with a high prevalence of tet(Y), tet(X), and tet(A) genes. This emphasizes the need for antibiotic stewardship, the detection of resistance profiles, and understanding underlying molecular mechanisms to plan clinical management effectively.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Scalable Design for a Pediatric Telemedicine and Medication Delivery Service: A Prospective Cohort Study in Haiti.","authors":"Molly B Klarman, Xiaofei Chi, Youseline Cajusma, Katelyn E Flaherty, Jude Ronald Beausejour, Lerby Exantus, Valery Madsen Beau de Rochars, Chantale Baril, Torben K Becker, Matthew J Gurka, Eric J Nelson","doi":"10.4269/ajtmh.24-0846","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0846","url":null,"abstract":"<p><p>Early access to health care is essential to avert morbidity and mortality. A telemedicine and medication delivery service (TMDS) is an innovative solution to address this need; however, pathways to scalability are unclear. We sought to evaluate a scalable pediatric TMDS. A TMDS in Haiti was configured for scalability by triaging severe cases to hospital-level care, nonsevere cases with higher clinical uncertainty to in-person examinations at households, and nonsevere cases with low clinical uncertainty to medication delivery alone. This design was evaluated in a prospective cohort study conducted among pediatric patients 10 years old or younger. Clinical and operational metrics were compared with a formative reference study in which all nonsevere patients received an in-person examination. The primary outcomes were rates of clinical improvement/recovery and in-person care seeking at 10 days. In total, 1,043 cases were enrolled in the scalable TMDS mode, and 19% (190) of nonsevere cases received an in-person examination; 382 cases were enrolled in the reference study, and 94% (338) of nonsevere cases received an in-person examination. At 10 days, rates of improvement were similar for the scalable and reference modes. Rates of participants who sought follow-up care were 15% in the scalable mode and 24% in the reference mode. In the context of a 5-fold reduction of in-person examinations, participants in the scalable mode had noninferior rates of improvement at 10 days. These findings highlight an innovative and now scalable solution to improve early access to health care without compromising safety.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Programmatic Addition of Clofazimine to Multidrug Therapy for Paucibacillary Leprosy in India: A One-Size-Fits-All Approach in Absence of Sound Clinical Evidence.","authors":"Akshita Jain, Soumit Sharma, Vishal Gupta, Anwita Khaitan","doi":"10.4269/ajtmh.25-0131","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0131","url":null,"abstract":"<p><p>In 2024, the Indian National Leprosy Eradication Program released Revised Treatment Guidelines for management of paucibacillary (PB) leprosy, introducing clofazimine into the existing PB multidrug therapy (PB-MDT). This treatment simplification has a dubious scientific basis and serious long-term implications. Notably, this policy shift is derived from WHO guidelines (2018), which issued only a conditional recommendation for uniform-MDT, relying on very low-quality evidence to support the change. We reviewed the studies cited in support and found multiple methodological shortcomings, including insufficient samples, lack of blinding, and unvalidated outcome measures. This significantly undermines the justification for incorporating clofazimine into PB-MDT. Leaving these limitations unaddressed could lead to unintended consequences, including increased drug resistance, higher treatment costs, and adverse drug effects, further complicating disease management. Such a fundamental policy revision should be preceded by rigorous, field-level research, preferably a multicentric, triple-blind superiority trial, alongside establishing surveillance for clofazimine resistance.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathoracic Echinococcosis: A 5-Year, Single-Center Experience.","authors":"Raffaella Lissandrin, Ambra Vola, Matilde Pelizzola, Federico Scopis, Stefano Meda, Cristiano Primiceri, Gianluca D'Alessandro, Tommaso Manciulli, Marcello Maestri, Enrico Brunetti, Pietro Rinaldi","doi":"10.4269/ajtmh.24-0094","DOIUrl":"https://doi.org/10.4269/ajtmh.24-0094","url":null,"abstract":"<p><p>Human cystic echinococcosis (CE) is caused by the larval forms of Echinococcus granulosus s.l. species complex that mainly affect the liver, with lung as the second most frequent location. We describe our experience with surgical treatment of lung CE, emphasizing the need for the least invasive approach when possible. Patients with intrathoracic CE who accessed our center from January 2019 to November 2023 were reviewed. Twenty-two patients, 12 males (54.5%), mean age 35 years, range 9-60, were treated. Eight patients (36.4%) had only lung involvement, seven (31.8%) had both liver and lung involvement, and seven (31.8%) had other locations. Thoracic surgery was required for large dimensions or pain (six each), hemoptysis (four each), skin fistulization and pericardial involvement (two each), and infection and emission of parasitic material by cough (one). A minimally invasive video-assisted thoracic surgery approach was used for 12 (54.5%) patients, whereas 10 underwent anterior thoracotomy. Three patients underwent sequential lung and hepatic surgery in a single session, one with myocardial wall involvement underwent thoracic and cardiac surgery in a single session. All patients received albendazole before and during surgery. There was no operative and postoperative mortality. The mean follow-up was 11.5 months (range 1-30). Patients with intrathoracic CE may present with acute and even life-threatening symptoms and should be managed preferably with tissue-sparing surgery by a multidisciplinary team in a referral center.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ear Sporotrichosis Mimicking Cutaneous Leishmaniasis.","authors":"Víctor M Tarango-Martínez, Arturo Robles-Tenorio, Jesus Alberto Cardenas-de la Garza, Lucio Vera-Cabrera","doi":"10.4269/ajtmh.25-0038","DOIUrl":"https://doi.org/10.4269/ajtmh.25-0038","url":null,"abstract":"<p><p>Sporotrichosis is an endemic mycosis caused by Sporothrix spp. We report the case of a 30-year-old male construction worker from Jalisco, Mexico. His symptoms initiated 20 years earlier with a pustule on his left ear, which evolved into an erythematous plaque that ulcerated and progressively destroyed the surrounding cartilage. Initial treatment of presumed cutaneous leishmaniasis was ineffective. Biopsies performed revealed chronic granulomatous dermatitis, and cultures on Sabouraud medium identified Sporothrix spp. Additionally, a sporotrichin intradermal test was performed, revealing a positive result. The patient achieved complete resolution after treatment with potassium iodide (6 g per day for 4 months). He declined reconstructive surgery. Infections by Sporothrix spp. can lead to lesions that can mimic other infectious or noninfectious causes such as cutaneous leishmaniasis. It is important to consider endemic mycosis even in unusual anatomical locations such as the auricle, especially when prior treatment has failed.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}