Laboratory medicine最新文献

Peripheral lymphocyte phenotypic characteristics in healthy populations across the lifespan, from infancy to older adults.

Laboratory medicine Pub Date : 2025-03-31 DOI: 10.1093/labmed/lmae117

Ting Wang, Rujia Chen, Renren Ouyang, Yun Wang, Wei Wei, Feng Wang, Shiji Wu, Hongyan Hou

{"title":"Peripheral lymphocyte phenotypic characteristics in healthy populations across the lifespan, from infancy to older adults.","authors":"Ting Wang, Rujia Chen, Renren Ouyang, Yun Wang, Wei Wei, Feng Wang, Shiji Wu, Hongyan Hou","doi":"10.1093/labmed/lmae117","DOIUrl":"https://doi.org/10.1093/labmed/lmae117","url":null,"abstract":"Introduction: Lymphocyte compartment undergoes dramatic changes during childhood and adulthood. Changes in lymphocyte subtypes with age, from infancy to senescence, are rare.Methods: A total of 364 healthy individuals were included in this study. The population was divided into 2 groups: children and adults.Results: The proportion of naive CD4 T cells decreased gradually in the children group (P < .001), and this decrease was significantly negatively correlated with the adult group (P = .008). Conversely, the percentage of memory CD4 T cells increased, with central memory CD4 T cells showing an increase in both groups and effector memory CD4 T cells especially increasing in the children group (P < .001). A similar pattern of changes was observed in naive CD8 T cells, memory CD8 T cells, and CD45RA-positive regulatory T cells. There was a negative correlation between age and the proportion of naive B cells in the children group (P < .001) as well as plasma B cells in the adult group (P < .001). Sex had no influence on the fluctuation of lymphocyte subsets. Furthermore, positive correlations were observed between the expression of T cells and B cells during the developmental process.Discussion: The observed trends in the distribution of naive and memory lymphocyte subsets offer valuable insights that can help physicians understand patients' immune state and assess prognostic conditions.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A 24-year-old man taking PrEP with unusual syphilis test results.

Laboratory medicine Pub Date : 2025-03-29 DOI: 10.1093/labmed/lmae114

Marika L Forsythe, Hong-Kee Lee

{"title":"A 24-year-old man taking PrEP with unusual syphilis test results.","authors":"Marika L Forsythe, Hong-Kee Lee","doi":"10.1093/labmed/lmae114","DOIUrl":"https://doi.org/10.1093/labmed/lmae114","url":null,"abstract":"Introduction: The antiretroviral regime emtricitabine-tenofovir disoproxil fumarate (Truvada [Gilead Sciences]) is a type of pre-exposure prophylaxis (PrEP) therapy used for the prevention and management of HIV infections. This protection, however, cannot be applied to other sexually transmitted infections (STIs), with many studies observing an increase in STI rates among individuals using PrEP.Methods: A 24-year-old man who had recently started PrEP with emtricitabine-tenofovir disoproxil fumarate was found to have a clinically significant elevation in syphilis total antibody count on STI screening, but his rapid plasma reagin (RPR) and Treponema pallidum particle agglutination (TP-PA) results remained negative. The patient was subsequently treated for a syphilis infection.Results: Post-treatment testing showed a negative syphilis total antibody result. The patient was suspected to have undergone treponemal antibody seroreversion, a rare but previously documented phenomenon following successful treatment.Discussion: This case highlights the possible effect of PrEP on the immune system, requiring closer surveillance to prevent acquisition of other STIs.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

In vivo and in vitro hemolysis in cold autoimmune hemolytic anemia.

Laboratory medicine Pub Date : 2025-03-28 DOI: 10.1093/labmed/lmae123

Mohammad Faiz Bin Masri, Yin Ye Lai, Siti Sarah Binti Mustapa, Intan Nureslyna Samsudin, Subashini Chellappah Thambiah

{"title":"In vivo and in vitro hemolysis in cold autoimmune hemolytic anemia.","authors":"Mohammad Faiz Bin Masri, Yin Ye Lai, Siti Sarah Binti Mustapa, Intan Nureslyna Samsudin, Subashini Chellappah Thambiah","doi":"10.1093/labmed/lmae123","DOIUrl":"https://doi.org/10.1093/labmed/lmae123","url":null,"abstract":"Introduction: Cold-reacting antibodies that bind to and trigger premature erythrocyte destruction are present in patients with cold autoimmune hemolytic anemia (cAIHA). The diagnosis of cAIHA is challenging because of the rarity of the disease, especially in patients with nonspecific features.Methods: In this case report, we discuss an unusual case of cAIHA in an older man who presented with asymptomatic hyperkalemia, highlighting the hematologic and biochemical changes associated with the disease.Results: Although hyperkalemia is expected with in vivo hemolysis because of autoantibody-mediated destruction of red blood cells, pseudohyperkalemia caused by in vitro hemolysis was also detected. The combination of actual in vivo hyperkalemia and pseudohyperkalemia resulted in a measured potassium value that was higher than the in vivo potassium concentration.Discussion: It is pertinent to consider both in vivo and in vitro hemolysis in patients with cAIHA, particularly when assessing potassium status, so that an appropriate intervention can be administered for better patient outcomes.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of a targeted next-generation sequencing-based CYP2D6 genotyping method compared with Sanger sequencing and multiplex ligation-dependent probe amplification.

Laboratory medicine Pub Date : 2025-03-26 DOI: 10.1093/labmed/lmae115

Won-Kyu Choi, Hyun-Ki Kim, Sollip Kim, Woochang Lee, Sail Chun

{"title":"Evaluation of a targeted next-generation sequencing-based CYP2D6 genotyping method compared with Sanger sequencing and multiplex ligation-dependent probe amplification.","authors":"Won-Kyu Choi, Hyun-Ki Kim, Sollip Kim, Woochang Lee, Sail Chun","doi":"10.1093/labmed/lmae115","DOIUrl":"https://doi.org/10.1093/labmed/lmae115","url":null,"abstract":"Introduction: CYP2D6 genotyping can guide the appropriate prescription of related drugs, but its complex genetic alterations make clinical implementation challenging. In this study, we evaluated the performance of a custom-made, targeted next-generation sequencing (NGS)-based CYP2D6 genotyping method by comparing it with Sanger sequencing and multiplex ligation-dependent probe amplification (MLPA) methods.Methods: CYP2D6 was included in a customized NGS multigene panel. CYP2D6 genotypes were analyzed in 91 patients, including copy number variations (CNV) analysis based on read depth. For comparison, single-nucleotide variations (formerly single-nucleotide polymorphisms) and CNVs were assessed using Sanger sequencing and MLPA, and the genotype was determined. Differences in genotype and predicted phenotype according to these 2 approaches were evaluated.Results: The NGS-based results were 100% concordant in single-nucleotide variations compared with Sanger sequencing, but 4 cases (4.4%) were discordant in CNVs with MLPA. Consequently, the NGS-based genotype was 95.6% concordant with the combined Sanger sequencing and MLPA approach. However, the classification of the predicted phenotype was unchanged in the 4 cases with differing assigned genotypes.Discussion: The NGS-based CYP2D6 genotyping method showed good performance, suggesting its potential utility in clinical practice. Including CYP2D6 in an NGS panel for patients who may use drugs metabolized by CYP2D6 may provide additional useful information.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Identification of cobra and viper bites in southern India using enzyme-linked immunosorbent assay.

Laboratory medicine Pub Date : 2025-03-26 DOI: 10.1093/labmed/lmae119

Tejeswara Rao Asuru, Raskin Erusan Rajagopal, Albert Rajendran, Gulistan Parveen, Anushka Das, Pabitha Devi, Swapan K Dasgupta, Shantaraman Kalyanaraman, Prasenjit Guchhait, Perumal Thiagarajan

{"title":"Identification of cobra and viper bites in southern India using enzyme-linked immunosorbent assay.","authors":"Tejeswara Rao Asuru, Raskin Erusan Rajagopal, Albert Rajendran, Gulistan Parveen, Anushka Das, Pabitha Devi, Swapan K Dasgupta, Shantaraman Kalyanaraman, Prasenjit Guchhait, Perumal Thiagarajan","doi":"10.1093/labmed/lmae119","DOIUrl":"https://doi.org/10.1093/labmed/lmae119","url":null,"abstract":"Introduction: Snakebite-related deaths are major concerns in populations worldwide that lack access to medical care. Current treatment of snakebites includes administration of polyspecific and polyvalent heterologous equine antiserum. Swift diagnosis of the species of snake responsible is essential to initiate a specific treatment.Methods: We generated murine monoclonal and rabbit polyclonal antibodies against the venom of the 3 most common venomous snakes in southern India: the Russell viper, the saw-scaled viper, and the Indian cobra. We developed an enzyme-linked immunosorbent assay to distinguish the snake by analyzing the exudates from the snakebite wound.Results: Monoclonal antibody EC3 reacts specifically with a 45- to 50-kDa venom protein of the saw-scaled viper, antibody NNH6 reacts with 12-kDa venom protein of the Indian cobra, and antibody RVV20 reacts with a 16-kDa venom protein of the Russell viper. We tested the exudates from snakebite wounds in 24 consecutive patients admitted to the Tirunelveli Medical College Hospital with snakebite. Our assay detected 18 patients with Russell viper bite and 1 each for cobra and saw-scaled viper.Discussion: Our study shows the feasibility of an enzyme-linked immunosorbent assay-based method to identify the 3 major venomous snakes in southern India and holds promise for prompt administration of snake-specific and mechanism-based treatment.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Markedly elevated serum level of presepsin in agranulocytosis with hematologic malignancy: A potential prognostic factor in a single-institution retrospective study after granulocyte transfusion.

Laboratory medicine Pub Date : 2025-03-26 DOI: 10.1093/labmed/lmae118

Takuya Fukumi, Keiko Fujii, Wataru Kitamura, Kazuhiro Ikeuchi, Naomi Asano, Akira Yamamoto, Hiroki Kobayashi, Takumi Kondo, Keisuke Seike, Hideaki Fujiwara, Noboru Asada, Daisuke Ennishi, Ken-Ichi Matsuoka, Fumio Otsuka, Yoshinobu Maeda, Nobuharu Fujii

{"title":"Markedly elevated serum level of presepsin in agranulocytosis with hematologic malignancy: A potential prognostic factor in a single-institution retrospective study after granulocyte transfusion.","authors":"Takuya Fukumi, Keiko Fujii, Wataru Kitamura, Kazuhiro Ikeuchi, Naomi Asano, Akira Yamamoto, Hiroki Kobayashi, Takumi Kondo, Keisuke Seike, Hideaki Fujiwara, Noboru Asada, Daisuke Ennishi, Ken-Ichi Matsuoka, Fumio Otsuka, Yoshinobu Maeda, Nobuharu Fujii","doi":"10.1093/labmed/lmae118","DOIUrl":"https://doi.org/10.1093/labmed/lmae118","url":null,"abstract":"Introduction: No established criteria exist for assessing the effectiveness of granulocyte transfusion (GTX) or biomarkers for predicting fatal infections in neutropenia. This study aimed to assess whether a novel sepsis marker, presepsin (P-SEP), is a useful prognostic indicator during GTX.Methods: We collected frozen serum from 8 patients who had undergone GTX between September 2022 and October 2023 and measured their P-SEP levels. We compared these results with clinical records and assessed the alterations before and after GTX and their association with prognosis.Results: The post-transfusion neutrophil count increased in all cases. In 5 of 8 patients (62.5%), P-SEP levels were reduced 1 day after GTX. Pretransfusion P-SEP levels were statistically significantly lower in the group of patients who survived and overcame infection after transfusion (GTX-survived) than in the group of patients who did not survive (GTX-nonsurvived) (1493 pg/mL vs 6658 pg/mL, P =.04). Transfused cell counts and changes in P-SEP levels 1 day after GTX were better in the GTX-survived group than in the GTX-nonsurvived group, although the difference was not statistically significant.Discussion: Presepsin is a biomarker that can be assessed in patients undergoing GTX for agranulocytosis. A clinically significant increase in P-SEP levels before GTX may indicate ineffective GTX and an unfavorable prognosis.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Electronic positive patient identification, computer provider order entry, and electronic remote blood issue implemented in operating rooms improve the safety and efficiency of blood transfusions. 在手术室实施病人电子身份确认、计算机医嘱输入和电子远程血液发放，可提高输血的安全性和效率。

Laboratory medicine Pub Date : 2025-03-26 DOI: 10.1093/labmed/lmae122

Nathan A Williams, Magali J Fontaine, Erika Reese, Megan Anders, Peter Rock, Parvez M Lokhandwala, Ashanpreet S Grewal

{"title":"Electronic positive patient identification, computer provider order entry, and electronic remote blood issue implemented in operating rooms improve the safety and efficiency of blood transfusions.","authors":"Nathan A Williams, Magali J Fontaine, Erika Reese, Megan Anders, Peter Rock, Parvez M Lokhandwala, Ashanpreet S Grewal","doi":"10.1093/labmed/lmae122","DOIUrl":"https://doi.org/10.1093/labmed/lmae122","url":null,"abstract":"Introduction: Blood transfusions are routinely performed in operation rooms. The process chain of performing ABO type, antibody screen, crossmatch, blood transport, and patient verification is complex. A multidisciplinary task force convened to improve the process of blood ordering and utilization identified 3 issues: (1) blood orders performed on paper included transcription errors; (2) guidelines for blood ordering practices were lacking, with inappropriate and arbitrary requests; and (3) there were long intervals between ordering and receiving blood in the operating room because of its distance from the blood bank.Methods: The task force implemented (1) an electronic positive patient identification (ePPID) system, (2) a standardized computer provider order entry (CPOE) for ordering blood for surgical patients, and (3) an electronic remote blood issuing (ERBI) system using refrigerators located within the operating suite.Results: Following ePPID implementation, transfusion documentation compliance rates improved from 71% to 98% and detected 2 patient safety issues. Implementation of CPOE with a maximum surgical blood order schedule and ERBI led to a substantial decline in blood product dispensed from coolers and reduced returns of unused red blood cells (from 30% to 15%) and plasma units (from 45% to 30%) to the blood bank over 2 years.Discussion: Electronic PPID, CPOE, and ERBI improved patient safety, workflow, and efficiency during blood transfusions.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

DNA variants in teratomatous and embryonal components of primary mediastinal nonseminomatous germ cell tumor: a case report and literature review.

Laboratory medicine Pub Date : 2025-03-26 DOI: 10.1093/labmed/lmae120

Jessica T Tran, Metha R Chea, Koushalya Sachdev, Joshua M Peterson, Gengming Huang, Song Han, Youmin Lin, Bryan Han, Juan Olano, Jianli Dong

{"title":"DNA variants in teratomatous and embryonal components of primary mediastinal nonseminomatous germ cell tumor: a case report and literature review.","authors":"Jessica T Tran, Metha R Chea, Koushalya Sachdev, Joshua M Peterson, Gengming Huang, Song Han, Youmin Lin, Bryan Han, Juan Olano, Jianli Dong","doi":"10.1093/labmed/lmae120","DOIUrl":"https://doi.org/10.1093/labmed/lmae120","url":null,"abstract":"Introduction: Primary germ cell tumors (GCTs) are highly malignant and often affect young adult men. They commonly occur in the reproductive organs but can also affect structures along the body's midline, including the mediastinum, retroperitoneum, and pineal gland.Methods: We present the genetic analyses of a 21-year-old African American man diagnosed with primary GCT of the anterior mediastinum.Results: DNA variants of NRAS and TP53 were identified in the teratomatous and embryonic components of his tumor. These variants were not identified in benign tissue, indicating their somatic origin. Several copy number variants were detected in both tumor components, including gains of chromosome 1, 3p, 12p with loss of homozygosity, and 21; segmental loss of 9q; and 13q copy neutral loss of homozygosity. Divergent copy number variants were identified in either teratomatous or embryonic components, including gains of chromosomes 7, 9, and 17 in the teratomatous component and gains of chromosomes 2, 4, 6, 8, and 11 in the embryonic component.Discussion: These DNA alterations may be genetic drivers of tumor initiation or progression in our patient. They may have diagnostic and prognostic value for mediastinal GCTs.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Thrombin-antithrombin complex might be a promising parameter for monitoring anticoagulation in the early postoperative period after LVAD implantation.

Laboratory medicine Pub Date : 2025-03-14 DOI: 10.1093/labmed/lmae113

Liqin Ling, Chaonan Liu, Jing Zhou

{"title":"Thrombin-antithrombin complex might be a promising parameter for monitoring anticoagulation in the early postoperative period after LVAD implantation.","authors":"Liqin Ling, Chaonan Liu, Jing Zhou","doi":"10.1093/labmed/lmae113","DOIUrl":"https://doi.org/10.1093/labmed/lmae113","url":null,"abstract":"Introduction: Appropriate bridging anticoagulation is critical in the early postoperative period after left ventricular assist device (LVAD) implantation, because the patients are usually in a fragile balance of thrombotic to bleeding risk. Unfortunately, the ideal manner of monitoring postoperative bridging anticoagulation remains undetermined.Methods: Here we reported a case demonstrating that thrombin-antithrombin complex might be an option in this situation.Results: This patient suffered thrombosis and bleeding simultaneously within 7 days after implantation, and the 2 commonly used methods for monitoring bridging anticoagulation, activated partial thromboplastin time and anti-Xa activity, were incompatible with each other. After a multi-disciplinary team discussion, the clinicians decided to manage his anticoagulation based on thrombin-antithrombin complex level. It worked out well, and the patient was transferred to a general ward 2 weeks later.Discussion: With respect to clinical endpoints, thrombin-antithrombin complex might be a promising parameter for monitoring anticoagulation in the early postoperative period after LVAD implantation.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The mechanisms of resistance, epidemiological characteristics, and molecular evolution of carbapenem-resistant hypervirulent Klebsiella pneumoniae. 耐碳青霉烯类药物的高病毒性肺炎克雷伯氏菌的耐药机制、流行病学特征和分子进化。

Laboratory medicine Pub Date : 2025-03-12 DOI: 10.1093/labmed/lmae110

Qun Wang, Mei-Yi Ye, Chi Hong, Zu-Pin Li, Lei Lin

{"title":"The mechanisms of resistance, epidemiological characteristics, and molecular evolution of carbapenem-resistant hypervirulent Klebsiella pneumoniae.","authors":"Qun Wang, Mei-Yi Ye, Chi Hong, Zu-Pin Li, Lei Lin","doi":"10.1093/labmed/lmae110","DOIUrl":"https://doi.org/10.1093/labmed/lmae110","url":null,"abstract":"Introduction: Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) is a highly pathogenic, drug-resistant, and transmissible \"superbug\" that causes infections in hospitals and communities. Because of the lack of effective antimicrobial treatment options, morbidity and mortality from CR-hvKP infections have increased dramatically, and outbreaks and the rapid spread of CR-hvKP in hospitals have become a major global public health challenge.Methods: The mechanisms of molecular evolution in CR-hvKP include the acquisition of a hypervirulent plasmid encoding a virulence gene by carbapenemase-producing K pneumoniae, the horizontal transfer of plasmids carrying carbapenem resistance genes to hvKP, and the acquisition of fusion plasmids carrying both carbapenem resistance genes and hypervirulent genes by classic K pneumoniae. In addition, hvKP can develop a resistance phenotype under antibiotic pressure.Results: CR-hvKP arises through plasmid-mediated convergence of resistance genes and virulence factors. Its multidrug resistance and lethal pathogenicity fuel hospital outbreaks, requiring urgent action to block plasmid transmission and strengthen surveillance to contain the spread of this evolving superbug.Discussion: In this article, we have summarized the carbapenemase resistance mechanism, evolution mechanism, virulence factors, and epidemiology of CR-hvKP. Our aim was to elucidate the molecular evolutionary mechanism of CR-hvKP and provide a reference for curbing the spread of CR-hvKP.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0