Search Results (2,180)

Nocardiosis is an infection caused by Gram-positive, saprophytic bacteria most often affecting immunocompromised hosts. The lungs, central nervous system, and skin are the sites most typically involved, although any organ may be affected. Skeletal involvement, particularly osteomyelitis, remains uncommon. This study is a review of all published cases of Nocardia osteomyelitis in humans, emphasizing epidemiology, microbiology, clinical features, management, and patient outcomes. A narrative review was performed using data from the PubMed/MedLine and Scopus databases. Fifty studies describing 55 patients were included. The median age was 54 years, and 65.5% were male. The main risk factors were immunosuppression (21.8%) and trauma (18.2%). The vertebrae constituted the most commonly affected site (25.5%), followed by the lower limb bones (20%); 23.6% had multifocal disease. Nocardia asteroides accounted for the majority of cases (34.8%). Trimethoprim-sulfamethoxazole was the most frequently administered agent (81.5%), followed by cephalosporins (29.6%) and carbapenems (27.8%). Overall mortality was 9.3%, with 5.6% of reported deaths directly attributed to the infection. Although uncommon, osteomyelitis due to Nocardia spp. should be considered when Gram-positive, filamentous microorganisms are detected in bone specimens, particularly in immunocompromised or post-trauma patients, as early suspicion and targeted therapy may improve survival. Full article

Parasites of the Leishmania genus are globally distributed and cause various clinical presentations in animals and humans, collectively known as leishmaniasis. The genomes of Leishmania and other trypanosomatids exhibit remarkable plasticity, shaped by several distinctive genetic features. Although these features can hinder the application of next-generation DNA sequencing (NGS) technologies, NGS data have been successfully used to characterize the whole-genome diversity of circulating Leishmania strains. The results complement and are broadly aligned with previous findings obtained with more traditional methods, offering greater resolution when working with geographically closer strains. In this review, we summarize advances over the past two decades in characterizing the genome diversity of Leishmania parasites using NGS strategies. We also discuss the application of these strategies to elucidate other aspects relevant to the epidemiology of these parasites, including their population structure and mode of reproduction. The vast majority of the studies to date have focused on species within the L. donovani/infantum complex or the L. (Viannia) subgenus, highlighting the need to incorporate other relevant underrepresented species and regions from both the Old and New World. Full article

African trypanosomiasis is a protozoan disease that affects both humans and animals. Human African Trypanosomiasis (HAT) is a Neglected Tropical Disease targeted for elimination in 2030. Although WHO has not reported HAT from Nigeria in the last decade, there are published studies reporting seroprevalence, parasite detection/isolation, and animal reservoirs potentially involved in HAT transmission in Nigeria. Interestingly, the burden of Animal African Trypanosomiasis (AAT) continues to increase. In this study, we synthesized published reports on the prevalence of HAT and AAT in Nigeria from 1993–2021, the trypanosome species involved, the spread of animal reservoirs, and the variability in diagnostic methodologies employed. A scoping review was performed following the methodological framework outlined in PRISMA-ScR checklist. Sixteen eligible studies published between 1993 and 2021 were reviewed: 13 for AAT and 3 for HAT. Varying prevalence rates were recorded depending on the diagnostic methods employed. The average prevalence reported from these studies was 3.3% (HAT), and 27.3% (AAT). Diagnostic methods employed include microscopy, PCR and Card Agglutination Test for Trypanosomiasis (CATT). Cattle, pigs, and dogs were identified as carriers of human-infective trypanosomes. This study highlights the scarcity of HAT epidemiological studies/data from Nigeria, the high prevalence, complex epidemiology, limited attention and surveillance of African Trypanosomiasis in Nigeria. Remarkably, WHO records do not reflect the published data showing evidence of HAT prevalence/cases in Nigeria. Unfortunately, diagnostics challenges and unrealistic disease reporting protocols seem to limit HAT reporting from Nigeria. Therefore, adequately coordinated epidemiological surveys and targeted intervention policies are imperative to ascertain the true epidemiological status of HAT in Nigeria and prevent disease re-emergence towards achieving WHO’s elimination targets. The presence of animal carriers of human-infective trypanosomes underscores the importance of a one-health approach to combat African trypanosomiasis effectively. Full article

Background: Tularemia is a zoonotic infection caused by Francisella tularensis, transmitted to humans through direct contact with infected animals, arthropod bites, or by ingesting contaminated water. It commonly presents with fever, lymphadenopathy, and oropharyngeal symptoms. In Turkey, where waterborne outbreaks are frequent, tularemia remains a significant public health concern. This study aimed to compare the clinical, epidemiological, and laboratory characteristics of patients diagnosed with tularemia and those with similar clinical features but seronegative results, with the goal of identifying parameters that may assist in differential diagnosis. Methods: This retrospective study included adults (≥18 years) who presented to the Infectious Diseases Outpatient Clinic between 2016 and 2024 with suspected tularemia and were tested using a microagglutination test (MAT). Patients with a positive MAT (≥1:160) or a fourfold titre increase were classified as tularemia cases, while seronegative patients were defined as tularemia-like cases. Demographic data, clinical symptoms, epidemiological risk factors, and laboratory findings were compared between the two groups. Results: A total of 105 patients were included, 54 (51.4%) of whom were diagnosed with tularemia. The duration from symptom onset to healthcare presentation was significantly longer in tularemia cases (20.3 ± 5.7 vs. 15.7 ± 6.2 days; p < 0.001). Sore throat (66.7% vs. 43.1%; p = 0.026) and tonsillitis/pharyngitis (55.6% vs. 21.6%; p = 0.001) were significantly more prevalent in the tularemia group. Epidemiological risk factors, including rural residence (92.6%), animal husbandry (74.1%), agricultural activity (72.2%), and contact with lake or stream water, were significantly more prevalent among tularemia cases (all p < 0.001). Alanine aminotransaminase (p = 0.019) and C-reactive protein levels (p = 0.027) were significantly lower in the tularemia group. Conclusions: Tularemia cases are associated with particular epidemiological risk factors and oropharyngeal symptoms. A thorough epidemiological evaluation is crucial for diagnosis, and enhancing awareness among healthcare providers and the public may facilitate earlier recognition and management. Full article

Viral metagenomic next-generation sequencing (vmNGS) has transformed our capacity for the untargeted detection and characterisation of (re)emerging zoonotic viruses, surpassing the limitations of traditional targeted diagnostics. In this review, we critically evaluate the current landscape of vmNGS, highlighting its integration within the One Health paradigm and its application to the surveillance and discovery of (re)emerging viruses at the human–animal–environment interface. We provide a detailed overview of vmNGS workflows including sample selection, nucleic acid extraction, host depletion, virus enrichment, sequencing platforms, and bioinformatic pipelines, all tailored to maximise sensitivity and specificity for diverse sample types. Through selected case studies, including SARS-CoV-2, mpox, Zika virus, and a novel henipavirus, we illustrate the impact of vmNGS in outbreak detection, genomic surveillance, molecular epidemiology, and the development of diagnostics and vaccines. The review further examines the relative strengths and limitations of vmNGS in both passive and active surveillance, addressing barriers such as cost, infrastructure requirements, and the need for interdisciplinary collaboration. By integrating molecular, ecological, and public health perspectives, vmNGS stands as a central tool for early warning, comprehensive monitoring, and informed intervention against (re)emerging viral threats, underscoring its critical role in global pandemic preparedness and zoonotic disease control. Full article

In Bhutan, information on rickettsiae is limited to a few epidemiological studies. There is no information on ticks and tick-associated rickettsiae. Ticks were collected opportunistically from domestic animals residing in eight districts where a seroprevalence study had been carried out previously. Morphological identification of the ticks was performed in the United States National Tick Collection and testing for rickettsiae was carried out in the Australian Rickettsial Reference Laboratory. Samples positive for rickettsiae by qPCR were subjected to conventional PCR followed by DNA sequencing and phylogenetic analysis. A total of 200 ticks were sampled from 155 domestic animals including cattle, dogs, goats, horses, yaks, sheep and cats. The ticks belonged to twelve different species, the commonest being Rhipicephalus microplus, followed by Rhipicephalus haemaphysaloides, Haemaphysalis sp. near ramachandrai, Haemaphysalis tibetensis, Haemaphysalis bispinosa, Haemaphysalis sp., Haemaphysalis sp. near davisi, Rhipicephalus sanguineus, Haemaphysalis shimoga, Haemaphysalis hystricis, Ixodes ovatus, and Amblyomma testudinarium. Rickettsial DNA sequence analysis showed that the rickettsiae infesting ticks in Bhutanese domestic animals aligned with R. gravesii, R. canadensis, R. honei, R. africae, R. felis, R. akari, R. australis, R. japonica, R. africae, R. heilongjiangensis, R. conorii, R. peacockii, R. honei, R. massiliae and R. rhipicephali. However, these may not be conclusive due to low bootstrap values in the phylogenetic tree. Bhutan will benefit from larger studies on ticks and tick-borne infections, burden and damage assessment to livestock and human health, public health interventions and clinical guidelines to reduce morbidity and mortality in human and animal health. Full article

At many recreational beaches, the health of visitors is protected through water quality monitoring programmes. However, visitors may also be exposed to microbiological pathogens in sand via ingestion, inhalation and skin contact. Microbiological pathogens that can cause human illness may be naturally found in beach sands, or introduced with people, animals or water entering the beach. The World Health Organization has recommended that recreational water safety plans consider microbial pathogens in beach sand. This review shows that a range of faecal and non-faecal pathogens can be detected in beach sand, but difficulty in determining whether exposure occurred via the sand or water means that there is insufficient evidence to link their presence with adverse human health effects. Proactively integrating beach sand testing into recreational water safety programmes will generate data to assess the impact of risk management activities. The use of faecal indicator bacteria to indicate elevated risk from faeces should be a priority where there are potential sources of contamination. This should be complemented with sanitary surveys and analyses that elucidate faecal contamination sources. The inclusion of non-faecal pathogens into monitoring programmes needs further, locally relevant justification through evidence from epidemiological studies and human health risk assessment. Full article

We investigated respiratory virus epidemiology in older adults across pre-pandemic (2007–2019), pandemic (2020–2022), and post-pandemic (2023–2024) periods, focusing on how public health interventions shaped surveillance, prevalence, and sex-specific trends. We conducted a retrospective cross-sectional study at a 1000-bed tertiary hospital in the Republic of Korea during 2007–2024, analyzing 4692 nasopharyngeal swab specimens collected from adults aged ≥ 65 years with suspected respiratory infections during 2007–2024. The specimens were tested for 15 respiratory viruses using multiplex real-time polymerase chain reaction. The outcomes included virus-specific detection rates and seasonal, sex-based and temporal trends before and after the COVID-19 pandemic. During the pre-pandemic period, older adults accounted for 13.2% of the tested individuals, which significantly increased to 52.0% in the later periods. Influenza A was the most frequently detected virus, followed by rhinovirus and human metapneumovirus. Influenza, RSV A/B, and coronaviruses 229E and OC43 showed peak positivity in winter, parainfluenza virus type 3 peaked in summer, and rhinovirus circulated year-round. Virus circulation was markedly suppressed during 2020–2022 and partially rebounded during 2023–2024. This study highlights the shift in diagnostic access and epidemiologic patterns of respiratory virus infections in older adults following the COVID-19 pandemic. Full article

End-of-life tyre (ELT) management is still a hot topic due to implications for sustainability and human health. This review aims to summarise the findings concerning the chemicals’ bio-accessibility/availability from the granular tyre-derived infill material used in sport surfaces. We included 14 original research articles and 5 reports (grey literature). The results included the analysis concerning volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), phthalates, metal(loid)s and other substances. The release of some dangerous chemicals was demonstrated, even though results must be considered critically. However, the chemicals’ bioaccessibility shows a highly nuanced picture and is not, per se, sufficient to determine the risk for the exposed subjects. The lack of bioavailability and epidemiological studies analysing the exposures in real scenarios resulted in one of the main issues concerning a proper evaluation of the potential risks for human health. Full article

Lower respiratory infections are a leading cause of death in children under five years. Human metapneumovirus (HMPV) is an underestimated causal agent of these infections. In this study, the molecular epidemiology of HMPV associated with respiratory infections in Mexican children between August 2023 and August 2024 was determined. Sequences were also analyzed for predicted N- and O-linked glycosylation sites. Overall, 34 sequences from infants with respiratory infections were obtained; 32 were assigned to the A2b2 genotype, one to A2b1, and one to B2. All but one of the A2b2 sequences carried the 111-nucleotide duplication of the G gene; the remaining sequence carried the 180-nucleotide duplication. The samples assigned to the A2b1 and B2 genotypes did not have a duplication. The HMPV-A phylogeny did not show a clustering of Mexican sequences as a single monophyletic group. Four N-linked glycosylation sites were predicted in the HMPV-A sequences and three in the B sequence. The number of O-linked glycosylation sites predicted in HMPV-A ranged from 61 to 77 and were 61 in the HMPV-B sequence. This first description of HMPV genotypes and the diverse array of G protein N- and O-linked glycosylation patterns found in a Mexican pediatric population in the post-pandemic period contributes to the understanding of the global spread of HMPV. Full article

This study evaluated the epidemiology and seasonal patterns of respiratory viruses in adults hospitalized with acute respiratory tract infections during two consecutive post-COVID-19 pandemic seasons. A retrospective study was conducted at the University Hospital “P. Giaccone”, Palermo, from September 2022 to September 2024. Multiplex molecular assays were used to detect the ten respiratory viruses most relevant from an epidemiological perspective in respiratory samples (n = 1110) of 1081 patients. A respiratory viral infection was identified in 29.6% of patients. The highest viral infection rate was observed in the 31–50 age group. Human rhinovirus/enterovirus (HRV/EV) was the most frequently detected (40%), followed by influenza A virus (IAV; 18.4%) and human coronaviruses (HuCoVs; 12.8%). Viral co-infections were identified in 10.9% of positive cases, with HRV/EV, adenovirus (ADV), and parainfluenza virus (PIV) being most frequently involved. Influenza and respiratory syncytial viruses (RSVs) showed a winter seasonality, while diverse circulation patterns were revealed for the other viruses. This study demonstrated a sustained circulation of respiratory viruses in adults hospitalized with severe respiratory symptoms, with HRV/EV accounting for most of them. Syndromic multiplex molecular testing, although limited to the detection of a small fraction of epidemiologically relevant known viruses, has proven to be a valuable tool, not only for diagnostic purposes but also for acquiring genotyping data and implementing epidemiological information from sentinel surveillance systems. Full article

Background/Objectives: Tea, the world’s second most consumed beverage after water, contains diverse phytochemicals that have garnered growing interest for their potential ability to modulate inflammasome activation. This study examined the antioxidant and anti-inflammatory properties of oolong tea (OLT) extracts, with a specific focus on their regulatory effects on NLRP3 inflammasome assembly—a critical mediator in chronic inflammatory diseases. Methods: OLT extracts were prepared from the Jin-Xuan cultivar with quantification for bioactive components (total phenolics, flavonoids, condensed tannins, and proanthocyanidins). J774A.1 murine macrophages were primed with LPS and stimulated with ATP to induce inflammasome activation. Therapeutic potentials of OLT extracts were assessed by measuring cytokine secretion, expression of NLRP3 inflammasome-related proteins (NLRP3, ASC, Caspase-1, and IL-1β), inflammasome complex formation, and ROS generation via biochemical assays, immunoblotting, and fluorescence microscopy. Results: OLT extracts, particularly at 100 µg/mL, markedly suppressed both the priming and activation phases of NLRP3 inflammasome formation. OLT treatment reduced IL-1β secretion by more than 50%, attenuated ASC oligomerization and speck formation, inhibited caspase-1 cleavage, and lowered intracellular ROS levels by approximately 50%. Conclusions: These findings suggest that OLT extracts exert potent anti-NLRP3 inflammasome activity and offer immunomodulation potential in preventing inflammation-related diseases such as infections, cancer, and neurodegenerative disorders. Further in vivo investigations, followed by clinical applications and epidemiological studies, are warranted to validate these preventive effects in human populations. Full article

Background: While rhinoviruses (RVs) typically cause mild respiratory infections, their persistence during the SARS-CoV-2 pandemic, particularly in Hong Kong’s strict zero-coronavirus disease 2019 policy, revealed unexpected epidemiological patterns. Two distinct RV surges emerged despite stringent public health measures, suggesting unique transmission advantages among circulating strains. We hypothesised that RV persistence during pandemic restrictions reflected strain-specific adaptations in respiratory tract replication efficiency and/or immune evasion. Methods: We analysed RV genotypes and conducted blinded clinical severity assessment for 96 paediatric hospitalisations during 2020–2021 outbreaks, compared with 180 age- and sex-matched control subjects from the corresponding weeks in pre-pandemic years (2018–2019). RV isolates from 2020 to 2021 outbreaks were characterised for their replication competence and transcriptomic responses in primary human nasal epithelial cell (HNEC) and environmental stability assays, using RV-A16 and RV-A1B as controls. Result: Minor group genotypes RV-A47 and RV-A49 were overrepresented during these two outbreaks. RV-A49 exhibited comparable replication efficiency to RV-A16 but induced significantly stronger transcriptomic responses, notably enhanced TNF and IL-1 signalling, in HNECs, alongside robust replication competence. Our data also suggests the association of RV-A49 with tachypnoea in 2021, particularly in younger males, though limited by a small sample size and single-centre design. Conclusion: The predominance of RV-A49 in hospitalised children during the SARS-CoV-2 pandemic potentially driven by its replication competence in HNECs and its capacity to enhanced inflammatory responses. The result is hypothesis-generating, warranting further studies with historical strains and broader populations to confirm strain-specific severity. Full article

Background/Objectives: Monitoring human papillomavirus (HPV) vaccine coverage worldwide can provide valuable insight into cervical cancer prevention. The aim of this manuscript was to assess the HPV vaccination coverage among the primary target cohort (9–14-year-old girls) in the world from 2010 to 2024. Methods: A descriptive epidemiological study (with an ecological study design) was carried out. Trends in HPV vaccination coverage were examined using the joinpoint regression analysis. Results: The HPV vaccination was introduced into the national schedule of 147 countries in 2024. Globally, coverage with the first dose of the HPV vaccine in the primary target cohort (9–14-year-old girls) was estimated at 56.9% in 2024. The growth trend in HPV vaccination coverage was significant mainly in the most developed countries (e.g., such as the USA, Canada and Germany), while trends were 10 times faster in other countries such as Armenia, Indonesia and Tanzania. A decline in trends of HPV vaccination coverage was significant in some developing countries (e.g., such as Panama, Sri Lanka, and Suriname) and in one of the most developed countries—the United Kingdom. Conclusions: A better understanding of changes in HPV vaccination coverage worldwide and further efforts to improve coverage to the target of 90% may contribute to more effective disease prevention. Full article

Non-communicable diseases (NCDs), including cancer and autoimmune, metabolic, cardiovascular, and neurodegenerative diseases, represent the leading cause of death globally and a growing healthcare burden. The gut microbiota (GM) has been recognized as a key biological component of host health that contributes to the maintenance of immune regulation, metabolic homeostasis, and epithelial barrier function. Several studies are now demonstrating that biological sex has an influence on both GM composition and function, which might explain sex differences in disease predisposition, course, and treatment response. Evidence from both clinical and experimental studies indicates that sex hormones, genetics, and lifestyle-related exposures interact with GM to influence the development and progression of most common NCDs. Some research suggests that estrogens promote diversity in GM with anti-inflammatory immune responses, while androgens and male-abundant taxa are associated with pro-inflammatory conditions. However, the evidence in humans is largely confounded by other variables (such as age, genetics, and lifestyle) and should be interpreted with caution. Unique GM metabolites, such as short-chain fatty acids and secondary bile acids, can have distinct, sex-specific effects on inflammation, metabolic regulation, and even antitumor immunity. While the existence of a sex–gut microbiota axis is gaining increased support, most studies in humans are cross-sectional epidemiological studies with limited mechanistic evidence and little consideration for sex as a biological variable. Future works should prioritize longitudinal, sex-stratified studies and utilize multi-omics integrated approaches to identify causal pathways. Ultimately, integrating sex differences into GM-based approaches could provide new avenues for personalized strategies for the prevention and treatment of NCDs. Full article