Sharma Shweta, Krishnaswamy Varun, Chaturvedi Rini, Sharma Amit
Molecular Medicine Division, International Centre for Genetic Engineering and Biotechnology, New Delhi, India.
ICMR-National Institute of Malaria Research, New Delhi, India.
IJID Reg. 2024 Mar 21;11:100359. doi: 10.1016/j.ijregi.2024.100359. eCollection 2024 Jun.
Rare human pathogens are infrequently observed clinically but can lead to undiagnosed infections, delays in treatment, severe complications, including death. Traditional diagnostic tools cannot routinely detect rare infections in public health settings. This study focuses on the incidence and outcomes of rare pathogenic microorganisms over 13 years (2010-2022) using PubMed database to obtain epidemiological data on rare bacterial, parasitic, and fungal infections in hospitals throughout India. A total of 974 articles were screened using case studies, datasets, comments, classical articles, letters, editorials, observational studies, and meta-analyses. Our analysis identified 28 rare bacteria, six parasites, and five fungal species infections in India. Fatal cases were associated with rare bacterial and fungal infections, including two from pan-drug-resistant bacteria (both from the genus). A total of 10 bacterial species displayed multi-drug resistance; one was extensively drug-resistant, and eight remained unclassified. Of the 83 patients with these rare infections, the mortality was ∼8.4% (seven of 83). Considering drug resistance and high mortality, prompt diagnosis of rare pathogens is crucial to controlling their spread. An increased awareness within the Indian health care system focusing on diagnostics, record keeping, and data sharing will be necessary to enhance surveillance.
罕见人类病原体在临床上很少被观察到，但可导致未确诊的感染、治疗延误、严重并发症，包括死亡。传统诊断工具无法在公共卫生环境中常规检测罕见感染。本研究利用PubMed数据库，聚焦13年（2010 - 2022年）间罕见致病微生物的发病率和转归情况，以获取印度各地医院中罕见细菌、寄生虫和真菌感染的流行病学数据。使用病例研究、数据集、评论、经典文章、信件、社论、观察性研究和荟萃分析对总共974篇文章进行了筛选。我们的分析确定了印度的28种罕见细菌、6种寄生虫和5种真菌物种感染。致命病例与罕见细菌和真菌感染有关，包括两例泛耐药细菌感染（均来自该属）。共有10种细菌表现出多重耐药性；1种为广泛耐药，8种仍未分类。在83例患有这些罕见感染的患者中，死亡率约为8.4%（83例中的7例）。考虑到耐药性和高死亡率，及时诊断罕见病原体对于控制其传播至关重要。印度医疗系统内提高对诊断、记录保存和数据共享的认识对于加强监测将是必要的。
