Microsphaeropsis arundinis skin and soft tissue infection in renal transplant recipients: three case reports and a review of the literature

Microsphaeropsis arundinis, a dematiaceous mold, is emerging as a cause of skin and soft tissue infection in immunocompromised hosts. Diagnosis is challenging because of the difficulty in identifying Microsphaeropsis species morphologically and few data are available to guide optimal management. We report 3 renal transplant recipients with M. arundinis soft tissue infection, where the etiological agent was diagnosed using DNA sequencing, and who were successfully treated with prolonged courses of extended‐spectrum triazole antifungal agents.     

A Polyprotein-Expressing Salmonid Alphavirus Replicon Induces Modest Protection in Atlantic Salmon (Salmo Salar) Against Infectious Pancreatic Necrosis

Vaccination is an important strategy for the control and prevention of infectious pancreatic necrosis (IPN) in farmed Atlantic salmon (Salmo salar) in the post-smolt stage in sea-water. In this study, a heterologous gene expression system, based on a replicon construct of salmonid alphavirus (SAV), was used for in vitro and in vivo expression of IPN virus proteins. The large open reading frame of segment A, encoding the polyprotein NH2-pVP2-VP4-VP3-COOH, as well as pVP2, were cloned and expressed by the SAV replicon in Chinook salmon embryo cells (CHSE-214) and epithelioma papulosum cyprini (EPC) cells. The replicon constructs pSAV/polyprotein (pSAV/PP) and pSAV/pVP2 were used to immunize Atlantic salmon (Salmo salar) by a single intramuscular injection and tested in a subsequent IPN virus (IPNV) challenge trial. A low to moderate protection against IPN was observed in fish immunized with the replicon vaccine that encoded the pSAV/PP, while the pSAV/pVP2 construct was not found to induce protection.     

Macrophages from disease resistant B2 haplotype chickens activate T lymphocytes more effectively than macrophages from disease susceptible B19 birds

Resistance to respiratory pathogens, including coronavirus-induced infection and clinical illness in chickens has been correlated with the B (MHC) complex and differential ex vivo macrophage responses. In the current study, in vitro T lymphocyte activation measured by IFNγ release was significantly higher in B2 versus B19 haplotypes. AIV infection of macrophages was required to activate T lymphocytes and prior in vivo exposure of chickens to NP AIV plasmid enhanced responses to infected macrophages. This study suggests that the demonstrated T lymphocyte activation is in part due to antigen presentation by the macrophages as well as cytokine release by the infected macrophages, with B2 haplotypes showing stronger activation. These responses were present both in CD4 and CD8 T lymphocytes. In contrast, T lymphocytes stimulated by ConA showed greater IFNγ release of B19 haplotype cells, further indicating the greater responses in B2 haplotypes to infection is due to macrophages, but not T cells. In summary, resistance of B2 haplotype chickens appears to be directly linked to a more vigorous innate immune response and the role macrophages play in activating adaptive immunity.     

新生儿感染诊断中降钙素原及超敏C-反应蛋白检测的临床意义

目的 探讨采用超敏C-反应蛋白(hs-CRP)和降钙素原(PCT)作为检测指标在新生儿感染诊断中的临床价值.方法 选取本院新生儿科2014年9月至2016年10月期间所收治新生儿60例作为观察对象,所有患儿均经诊断确诊为感染性疾病,将其作为观察组,另选取同期本院体检健康新生儿60例作为对照组,对两组新生儿进行血清降钙素原、超敏C反应蛋白检测,其中超敏C反应蛋白行散射比浊法检测,降钙素原行双抗体夹心精标法检测,对两组新生儿相关指标检测结果进行对比分析.结果 观察组新生儿其白细胞计数、hs-CRP水平、PCT水平均明显高于对照组,差异具有统计学意义(P＜0.05);同PCT相比,hs-CRP对于新生儿感染性疾病的诊断灵敏度、特异性均处于较低水平;同单一指标检测相比,PCT联合hs-CPR检测对于新生儿感染性疾病的诊断灵敏度、特异性均处于较高水平.结论 在新生儿感染性疾病中,血清超敏C-反应蛋白、降钙素原均存在显著的特异性变化,可作为感染性疾病的鉴别、诊断指标,其中降钙素原对于新生儿感染性疾病的诊断灵敏度、特异性优于超敏C-反应蛋白,采用二者进行联合检测可有效提高对于此类患儿的临床诊断价值.     

Waiting in the wings: The potential of mosquito transmitted flaviviruses to emerge

The sudden dramatic emergence of the mosquito transmitted flavivirus Zika virus has bought to the world’s attention a relatively obscure virus that was previously only known to specialist researchers. The genus Flavivirus of the family Flaviviridae contains a number of well-known mosquito transmitted human pathogenic viruses including the dengue, yellow fever, Japanese encephalitis and West Nile viruses. However, the genus also contains a number of lesser known human pathogenic viruses transmitted by mosquitoes including Wesselsbron virus, Ilheus virus, St. Louis encephalitis virus and Usutu virus. This review summarizes our knowledge of these lesser known mosquito transmitted flaviviruses and highlights their potential to emerge.     

Fluorescence in situ hybridization (FISH) in the microbiological diagnostic routine laboratory: a review

Early identification of microbial pathogens is essential for rational and conservative antibiotic use especially in the case of known regional resistance patterns. Here, we describe fluorescence in situ hybridization (FISH) as one of the rapid methods for easy identification of microbial pathogens, and its advantages and disadvantages for the diagnosis of pathogens in human infections in the laboratory diagnostic routine. Binding of short fluorescence-labeled DNA or nucleic acid-mimicking PNA probes to ribosomes of infectious agents with consecutive analysis by fluorescence microscopy allows identification of bacterial and eukaryotic pathogens at genus or species level. FISH analysis leads to immediate differentiation of infectious agents without delay due to the need for microbial culture. As a microscopic technique, FISH has the unique potential to provide information about spatial resolution, morphology and identification of key pathogens in mixed species samples. On-going automation and commercialization of the FISH procedure has led to significant shortening of the time-to-result and increased test reliability. FISH is a useful tool for the rapid initial identification of microbial pathogens, even from primary materials. Among the rapidly developing alternative techniques, FISH serves as a bridging technology between microscopy, microbial culture, biochemical identification and molecular diagnostic procedures.     

对2019年新型冠状病毒肺炎疫情防控的思考

新型冠状病毒肺炎的暴发为人类敲响了一记警钟。新发传染病因其病原体的未知性、流行过程的复杂性、传播速度的快速性给公众健康、社会经济都带来了巨大损失，其防控更是传染病防控的重点。One Health策略是21世纪快速发展的应对全球公共卫生问题的新型措施，它注重人类、动物、环境间的关联性，强调跨学科、跨部门、跨领域的合作，在新发传染病防控方面具有重要意义。本文从One Health的角度对新型冠状病毒肺炎疫情的防控措施进行探讨，进一步阐明One Health策略在新发传染病防控中的重要作用。     

Severe infectious diseases of childhood as monogenic inborn errors of immunity

This paper reviews the developments that have occurred in the field of human genetics of infectious diseases from the second half of the 20th century onward. In particular, it stresses and explains the importance of the recently described monogenic inborn errors of immunity underlying resistance or susceptibility to specific infections. The monogenic component of the genetic theory provides a plausible explanation for the occurrence of severe infectious diseases during primary infection. Over the last 20 y, increasing numbers of life-threatening infectious diseases striking otherwise healthy children, adolescents, and even young adults have been attributed to single-gene inborn errors of immunity. These studies were inspired by seminal but neglected findings in plant and animal infections. Infectious diseases typically manifest as sporadic traits because human genotypes often display incomplete penetrance (most genetically predisposed individuals remain healthy) and variable expressivity (different infections can be allelic at the same locus). Infectious diseases of childhood, once thought to be archetypal environmental diseases, actually may be among the most genetically determined conditions of mankind. This nascent and testable notion has interesting medical and biological implications.This paper reviews the monogenic inborn errors of immunity that have been shown to underlie resistance or vulnerability to human infectious diseases. These studies, first conducted in the 1970s, gained momentum from the mid-1990s onward. The analysis of Mendelian traits was followed by that of non-Mendelian monogenic traits, characterized by incomplete clinical penetrance and variable expressivity.     

双歧三联活菌片联合蒙脱石散治疗小儿腹泻疗效及对患儿免疫功能的影响

目的探讨双歧三联活菌片联合蒙脱石散治疗小儿腹泻疗效及对患儿免疫功能的影响。方法 110例符合入选标准的小儿腹泻患儿随机分为对照组(n=55)和观察组(n=55)。对照组在常规治疗的基础上给予蒙脱石散治疗,观察组在对照组的基础上联合应用双歧三联活菌片治疗。疗程结束后,观察比较两组治疗疗效、临床指标恢复正常时间及免疫功能情况。结果观察组治疗总有效率为92.7%,明显高于对照组的78.2%(P0.05)。与对照组治疗后相比,观察组发热消退、呕吐缓解、腹痛缓解、大便恢复正常及粪便常规恢复正常时间等临床指标均显著缩短,而免疫功能指标Ig A、Ig G和CD4/CD8比值均明显升高(P均0.05)。结论双歧三联活菌片联合蒙脱石散治疗小儿腹泻疗效可靠,能够提高治疗疗效,快速缓解症状,提高机体免疫功能,临床上值得进一步研究。