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通过临床实验室的基于云的网络进行实时胃肠道感染监测。

Real-time gastrointestinal infection surveillance through a cloud-based network of clinical laboratories.

机构信息

Center for Environmental Health, Risk and Sustainability, RTI International, Research Triangle Park, North Carolina, United States of America.

Biomathematics, BioFire Diagnostics, Salt Lake City, Utah, United States of America.

出版信息

PLoS One. 2021 Apr 30;16(4):e0250767. doi: 10.1371/journal.pone.0250767. eCollection 2021.

Abstract

Acute gastrointestinal infection (AGI) represents a significant public health concern. To control and treat AGI, it is critical to quickly and accurately identify its causes. The use of novel multiplex molecular assays for pathogen detection and identification provides a unique opportunity to improve pathogen detection, and better understand risk factors and burden associated with AGI in the community. In this study, de-identified results from BioFire® FilmArray® Gastrointestinal (GI) Panel were obtained from January 01, 2016 to October 31, 2018 through BioFire® Syndromic Trends (Trend), a cloud database. Data was analyzed to describe the occurrence of pathogens causing AGI across United States sites and the relative rankings of pathogens monitored by FoodNet, a CDC surveillance system were compared. During the period of the study, the number of tests performed increased 10-fold and overall, 42.6% were positive for one or more pathogens. Seventy percent of the detections were bacteria, 25% viruses, and 4% parasites. Clostridium difficile, enteropathogenic Escherichia coli (EPEC) and norovirus were the most frequently detected pathogens. Seasonality was observed for several pathogens including astrovirus, rotavirus, and norovirus, EPEC, and Campylobacter. The co-detection rate was 10.2%. Enterotoxigenic E. coli (ETEC), Plesiomonas shigelloides, enteroaggregative E. coli (EAEC), and Entamoeba histolytica were detected with another pathogen over 60% of the time, while less than 30% of C. difficile and Cyclospora cayetanensis were detected with another pathogen. Positive correlations among co-detections were found between Shigella/Enteroinvasive E. coli with E. histolytica, and ETEC with EAEC. Overall, the relative ranking of detections for the eight GI pathogens monitored by FoodNet and BioFire Trend were similar for five of them. AGI data from BioFire Trend is available in near real-time and represents a rich data source for the study of disease burden and GI pathogen circulation in the community, especially for those pathogens not often targeted by surveillance.

摘要

急性胃肠道感染(AGI)是一个重大的公共卫生问题。为了控制和治疗 AGI,快速准确地确定其病因至关重要。新型多重分子检测方法可用于病原体检测和鉴定,为提高病原体检测能力,更好地了解社区中与 AGI 相关的危险因素和负担提供了独特的机会。在这项研究中,通过 BioFire® Syndromic Trends(Trend)云数据库,从 2016 年 1 月 1 日至 2018 年 10 月 31 日,获取了 BioFire® FilmArray® Gastrointestinal(GI)Panel 的去识别结果。对数据进行了分析,以描述美国各地引起 AGI 的病原体的发生情况,并比较了疾病预防控制中心监测系统 FoodNet 监测的病原体的相对排名。在研究期间,检测数量增加了 10 倍,总体而言,有 42.6%的检测结果为一种或多种病原体阳性。70%的检测结果为细菌,25%为病毒,4%为寄生虫。艰难梭菌、肠致病性大肠杆菌(EPEC)和诺如病毒是最常检测到的病原体。几种病原体(包括星状病毒、轮状病毒和诺如病毒、EPEC 和弯曲杆菌)都具有季节性。肠毒素性大肠杆菌(ETEC)、类志贺邻单胞菌、聚集性肠致病性大肠杆菌(EAEC)和溶组织内阿米巴的检测率超过 60%,而艰难梭菌和环孢子虫的检测率不到 30%。还发现共同检测的阳性率之间存在相关性,如志贺菌/肠侵袭性大肠杆菌与溶组织内阿米巴,以及 ETEC 与 EAEC。总体而言,FoodNet 和 BioFire Trend 监测的 8 种胃肠道病原体的检测相对排名中,有 5 种的排名相似。BioFire Trend 的 AGI 数据可近乎实时获得,为研究社区疾病负担和胃肠道病原体循环提供了丰富的数据来源,尤其是对于那些不常被监测的病原体。

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