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尼日尔结膜炎病例中的病原体及抗菌药物耐药性全面分析

Comprehensive Profile of Pathogens and Antimicrobial Resistance in Conjunctivitis Cases from Niger.

机构信息

Programme Nationale de Santé Oculaire, Niamey, Niger.

Francis I. Proctor Foundation, University of California, San Francisco, California.

出版信息

Am J Trop Med Hyg. 2023 Nov 6;109(6):1333-1338. doi: 10.4269/ajtmh.23-0498. Print 2023 Dec 6.

Abstract

Infectious conjunctivitis outbreaks remain a public health burden. This study focuses on the pathogen and antimicrobial resistance (AMR) profiles identified in Niger. Sixty-two patients with acute infectious conjunctivitis who presented to health posts were enrolled from December 2021 to May 2022. Nasal and conjunctival swabs were obtained from each patient. Unbiased RNA deep sequencing (RNA-seq) was used to identify associated pathogens. A pathogen was identified in 39 patients (63%; 95% CI, 50-74). Of those, an RNA virus was detected in 23 patients (59%; 95% CI, 43-73). RNA viruses were diverse and included human coronaviruses (HCoVs): SARS-CoV-2, HCoV-229E, HCoV-HKU1, and HCoV-OC43. A DNA virus was identified in 11 patients (28%; 95% CI, 17-44). Of those, four patients had a coinfection with an RNA virus and two patients had a coinfection with both an RNA virus and a bacterium. DNA viruses were predominantly human herpesvirus (cytomegalovirus, Epstein-Barr virus, human herpesvirus 8) and human adenovirus species B, C, and F. Eighteen patients (46%; 95% CI, 32-61) had a bacteria-associated infection that included Haemophilus influenza, Haemophilus aegyptius, Staphylococcus aureus, Streptococcus pneumoniae, and Moraxella spp. Antimicrobial resistance determinants were detected in either the conjunctiva or nasal samples of 20 patients (32%; 95% CI, 22-45) and were found to be more diverse in the nose (Shannon alpha diversity, 1.12 [95% CI, 1.05-1.26] versus 1.02 [95% CI, 1.00-1.05], P = 0.01). These results suggest the potential utility of leveraging RNA-seq to surveil pathogens and AMR for ocular infections.

摘要

传染性结膜炎疫情仍然是一个公共卫生负担。本研究关注的是在尼日尔发现的病原体和抗生素耐药性(AMR)特征。2021 年 12 月至 2022 年 5 月,从 62 名患有急性传染性结膜炎的患者中采集了鼻腔和结膜拭子。对每位患者均进行了鼻腔和结膜拭子的采集。采用无偏 RNA 深度测序(RNA-seq)技术来鉴定相关病原体。在 39 名患者(63%;95%置信区间,50-74)中确定了病原体。其中,23 名患者(59%;95%置信区间,43-73)检测到 RNA 病毒。RNA 病毒种类繁多,包括人类冠状病毒(HCoVs):SARS-CoV-2、HCoV-229E、HCoV-HKU1 和 HCoV-OC43。11 名患者(28%;95%置信区间,17-44)检测到 DNA 病毒。其中,4 名患者同时感染了 RNA 病毒,2 名患者同时感染了 RNA 病毒和细菌。DNA 病毒主要为人疱疹病毒(巨细胞病毒、EB 病毒、人疱疹病毒 8)和人类腺病毒属 B、C 和 F。18 名患者(46%;95%置信区间,32-61)存在细菌相关感染,包括流感嗜血杆菌、埃及嗜血杆菌、金黄色葡萄球菌、肺炎链球菌和莫拉菌属。在 20 名患者(32%;95%置信区间,22-45)的结膜或鼻腔样本中检测到抗生素耐药决定因素,且在鼻腔中发现的耐药决定因素更加多样(Shannon alpha 多样性,1.12[95%置信区间,1.05-1.26]与 1.02[95%置信区间,1.00-1.05],P=0.01)。这些结果表明,利用 RNA-seq 监测眼部感染的病原体和 AMR 具有潜在的应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11a1/10793053/7123f1e8c30c/ajtmh.23-0498f1.jpg

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