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Treatment quality and outcome for multidrug-resistant tuberculosis patients in four regions of China: a cohort study

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infectious diseases of Poverty 2020年第4期9卷 75-83页

作者： Xu-Bin Zheng Vinod K.Diwan Qi Zhao Yi Hu Judith Bruchfeld Wei-Li Jiang Sven Hoffner Biao Xu Department of epidemiology School of Public Health and Key Laboratory of Public Health Safety(Ministry of Education)Fudan University130 Dong An RoadShanghai 200032China Department of Global Public Health Karolinska InstitutetStockholmSweden Department of infectious diseases Karolinska University HospitalStockholmSweden division of infectious diseases Department of Medicine SolnaKarolinska InstitutetStockholmSweden

Background:China incurs an extremely low treatment coverage of multidrug-resistant tuberculosis(MDR-TB).This study aimed to understand the experience of MDR-TB patients on quality of health care,and the clinical impact through an up to six-year follow-up.Methods:Cohorts of MDR-TB patients were built in TB/MDR-TB designated hospitals in four regions of China from 2014 to 2015.Patients were followed up during treatment course,and yearly confirmation afterward until 2019.Delay in MDR-TB diagnosis and treatment was calculated upon bacteriological confirmation and treatment initiation.Risk factors for unfavourable outcomes were identified by multivariate logistic regression.Results:Among 1168 bacteriological-positive TB patients identified from a 12-million population,58(5.0%)MDR-TB cases were detected.The median delay for MDR-TB diagnosis was 90.0 days,with 13.8%having a delay above 180.0 days.MDR-TB treatment was only recommended to 19(32.8%)participants,while the rest continued with regimen for drug-susceptible TB.In MDR-TB treatment group,36.8%achieved treatment success,while the others had incomplete treatment(21.1%),loss to follow-up(36.8%)and TB relapse(5.3%).For non-MDR-TB treatment group,33.3%succeeded,25.6%relapsed,2.6%failed,23.1%died,and 15.4%were lost to follow-up.Overall,only 35.7%(20/56)of detected MDR-TB patients had favourable outcomes and higher education level was positively associated with it(adjusted odds ratio[aOR]:3.60,95%confidence interval[CI]:1.04-12.5).Conclusions:A large proportion of patients did not receive MDR-TB treatment and had unfavourable outcomes.Delayed MDR-TB diagnosis resulted in poor quality of MDR-TB care.Rapid diagnosis,regulated patient management and high-quality MDR-TB treatment should be enhanced in China.

关键词： Multidrug-resistant Tuberculosis Delay Treatment Follow-up China

Willingness of the General Public to Receive A COVID-19 Vaccine Booster—China,April–May 2021

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China CDC weekly 2022年第4期4卷 66-70页

作者： Xiaoxiao Wang Leyuan Liu Minyue Pei Xiaoguang Li Nan Li Research Center of Clinical epidemiology Peking University Third HospitalBeijingChina Department of infectious diseases Peking University Third HospitalBeijingChina

Summary What is already known about this topic?A coronavirus disease 2019(COVID-19)vaccine booster is planned for administration to eligible individuals.Understanding the factors that influence attitudes towards the booster shot will help to identify groups that will most readily accept a booster dose.What is added by this report?Of the individuals polled,75.2%reported they would receive a booster shot.Sociodemographic characteristics influencing booster vaccine acceptance included age,gender,occupation,and education.Moreover,those who had been vaccinated against influenza,who believed herd immunity would be effective against severe acute respiratory syndrome coronavirus 2,and who reported reduced anxiety after vaccination were more likely to accept a booster dose.What are the implications for public health practice?A booster shot of the COVID-19 vaccine could be widely accepted.Communicating about the effectiveness of the COVID-19 vaccine and the impact of infection on people’s health could help increase public willingness to get a booster dose.

关键词： occupation immunity COV

The Group A Streptococcus Interleukin-8 Protease SpyCEP Promotes Bacterial Intracellular Survival by Evasion of Autophagy

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infectious Microbes & diseases 2022年第3期4卷 116-123页

作者： RenéBergmann Giuseppe Gulotta Federica Andreoni Tomoko Sumitomo Shigetada Kawabata Annelies S.Zinkernagel Gursharan S.Chhatwal Victor Nizet Manfred Rohde Satoshi Uchiyama Central Unit for Microscopy(ZEIM) Helmholtz Centre for Infection ResearchBraunschweigGermany Division of Infectious Diseases and Hospital Epidemiology University Hospital ZurichZurichSwitzerland Department of Oral and Molecular Microbiology Osaka University Graduate School of DentistrySuita-OsakaJapan division of Host-Microbe Systems and Therapeutics Department of PediatricsUniversity of CaliforniaSan DiegoLa JollaCalifornia

Autophagy serves an innate immune function in defending the host against invading bacteria,including group A Streptococcus(GAS).Autophagy is regulated by numerous host proteins,including the endogenous negative regulator calpain,a cytosolic protease.Globally disseminated serotypeM1T1 GAS strains associated with high invasive disease potential express numerous virulence factors and resist autophagic clearance.Upon in vitro infection of human epithelial cell lines with representative wild-type GAS M1T1 strain 5448(M1.5448),we observed increased calpain activation linked to a specific GAS virulence factor,the interleukin-8 protease SpyCEP.Calpain activation inhibited autophagy and decreased capture of cytosolic GAS in autophagosomes.In contrast,the serotype M6 GAS strain JRS4(M6.JRS4),which is highly susceptible to host autophagy-mediated killing,expresses low levels of SpyCEP and does not activate calpain.Overexpression of SpyCEP in M6.JRS4 stimulated calpain activation,inhibited autophagy,and significantly decreased bacterial capture in autophagosomes.These paired loss-and gain-of-function studies reveal a novel role for the bacterial protease SpyCEP in enabling GAS M1 evasion of autophagy and host innate immune clearance.

关键词： group A Streptococcus SpyCEP virulence factor epithelial cells intracellular survival autophagy xenophagy calpain

Evaluating active leprosy case identifcation methods in six districts of Nepal

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infectious diseases of Poverty 2023年第6期12卷 105-106页

作者： Ram Kumar Mahato Uttam Ghimire Madhav Lamsal Bijay Bajracharya Mukesh Poudel Prashnna Napit Krishna Lama Gokarna Dahal David T.S.Hayman Ajit Kumar Karna Basu Dev Pandey Chuman Lal Das Krishna Prasad Paudel epidemiology and Disease Control division Department of Health Services Ministry of Health and Population Kathmandu Nepal epidemiology and Disease Control division-Malaria Program Management Unit- SCI-GF Kathmandu Nepal Leprosy Control & Disability Management Section EPidemiology and Disease Control Division DoHS Kathmandu Nepal Lalgadh Leprosy hospital & Service Center Nepal Leprosy Trust Lalgadh Nepal Molecular epidemiology and Public Health Laboratory Infectious Disease Research Centre Hopkirk Research Institute Massey University Palmerston North New Zealand Center for Health and Disease Studies-Nepal Kathmandu Nepal DEJIMA infectious Disease Research Alliance Nagasaki University Nagasaki Japan

Background Nepal has achieved and sustained the elimination of leprosy as a public health problem since 2009,but 17 districts and 3 provinces with 41%(10,907,128)of Nepal’s population have yet to eliminate the disease.Pediatric cases and grade-2 disabilities(G2D)indicate recent transmission and late diagnosis,respectively,which necessitate active and early case detection.This operational research was performed to identify approaches best suited for early case detection,determine community-based leprosy epidemiology,and identify hidden leprosy cases early and respond with prompt treatment.Methods Active case detection was undertaken in two Nepali provinces with the greatest burden of leprosy,Madhesh Province(40%national cases)and Lumbini Province(18%)and at-risk prison populations in Madhesh,Lumbini and Bagmati provinces.Case detection was performed by(1)house-to-house visits among vulnerable populations(n=26,469);(2)contact examination and tracing(n=7608);in Madhesh and Lumbini Provinces and,(3)screening prison populations(n=4428)in Madhesh,Lumbini and Bagmati Provinces of Nepal.Per case direct medical and nonmedical costs for each approach were calculated.Results New case detection rates were highest for contact tracing(250),followed by house-to-house visits(102)and prison screening(45)per 100,000 population screened.However,the cost per case identifed was cheapest for house-to-house visits[Nepalese rupee(NPR)76,500/case],followed by contact tracing(NPR 90,286/case)and prison screening(NPR 298,300/case).House-to-house and contact tracing case paucibacillary/multibacillary(PB:MB)ratios were 59:41 and 68:32;female/male ratios 63:37 and 57:43;pediatric cases 11%in both approaches;and grade-2 disabilities(G2D)11%and 5%,respectively.Developing leprosy was not signifcantly diferent among household and neighbor contacts[odds ratios(OR)=1.4,95%confdence interval(CI):0.24-5.85]and for contacts of MB versus PB cases(OR=0.7,95%CI 0.26-2.0).Attack rates were not signifcantly diferent among household contacts of MB cases(0.3

关键词： Leprosy Early case detection Community-based epidemiology Hidden case New case detection rate Attack rate Cost per case identifed Nepal

Pulmonary Bacterial Infection and Liver Cirrhosis: Current Status and Treatment

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infectious Microbes & diseases 2024年第1期6卷 5-10页

作者： Yingying Zhao Song Yang Huichun Xing Center of Liver diseases division 3 Beijing Ditan HospitalCapital Medical UniversityBeijingChina.

Liver cirrhosis has a higher incidence rate and mortality when complicated with bacterial infections.Concomitant bacterial infections,especially bacterial pneumonia,increase the susceptibility of cirrhotic patients to decompensation,with a higher likelihood of mortality.Bacterial pneu-monia is often overlooked in patients with liver cirrhosis,although it can impact the clinical progress and outcomes.Untimely diagnosis and inappropriate antibiotic treatments are associated with poor prognosis and increased mortality.Current understanding of mechanisms and appropriate antibiotic treatments for cirrhosis-related bacterial pneumonia remain inadequate.Herein,we reviewed the epidemiology,clinical characteristics and treatment of pulmonary bacterial infections in cirrhotic patients to provide suggestions for clinical practice.

关键词： bacterial pneumonia liver cirrhosis epidemiology characteristics treatment

Epidemic Features of COVID-19 and Potential Impact of hospital Strain During the Omicron Wave—Australia,2022

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China CDC weekly 2023年第7期5卷 165-169,I0001-I0006页

作者： Jingli Yang Hannah McClymont Liping Wang Sotiris Vardoulakis Wenbiao Hu School of Public Health and Social Work Queensland University of TechnologyBrisbaneAustralia College of Earth and Environmental Sciences Lanzhou UniversityLanzhou CityGansu ProvinceChina division of infectious diseases Chinese Center for Diseases Control and PreventionBeijing MunicipalityChina National Centre for epidemiology and Population Health College of Health and MedicineThe Australian National UniversityCanberraAustralia Healthy Environments And Lives(HEAL)National Research Network Australia

Summary What is already known about this topic?hospitals have experienced a surge in admissions due to the increasing number of Omicron cases.Understanding the epidemiological features of coronavirus disease 2019(COVID-19)and the strain it places on hospitals will provide scientific evidence to help policymakers better prepare for and respond to future outbreaks.What is added by this report?The case fatality rate of COVID-19 was 1.4 per 1,000 persons during the Omicron wave.

关键词： Impact COV policy

Mycobacterium tuberculosis latency-associated antigen Rv1733c SLP improves the accuracy of differential diagnosis of active tuberculosis and latent tuberculosis infection

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Chinese Medical Journal 2022年第1期135卷 63-69页

作者： Lifan Zhang Huimin Ma Shijun Wan Yueqiu Zhang Mengqiu Gao Xiaoqing Liu division of infectious diseases Department of Internal MedicineState Key Laboratory of Complex Severe and Rare DiseasePeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Clinical epidemiology Unit Peking Union Medical CollegeInternational Clinical Epidemiology NetworkBeijing 100730China Center for Tuberculosis Research Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Tuberculosis Beijing Chest HospitalCapital Medical University/Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing 101149China

Background: Differential diagnosis of active tuberculosis (ATB) and latent tuberculosis infection (LTBI) has been a challenge for clinicians in high TB burden countries. The purpose of this study was to improve the accuracy of differential diagnosis of ATB and LTBI by using fluorescent immunospot (FluoroSpot) assay to detect specific Th1 cell immune responses. The novelmycobacterium tuberculosis (MTB) latency-associated antigens Rv1733c and synthetic long peptides derived from Rv1733c (Rv1733c SLP) were used based on virulence factors early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10).Methods: Fifty-seven ATB cases, including 20 pathogen-confirmed ATB and 37 clinically diagnosed ATB, and 36 LTBI cases, were enrolled between January and December 2017. FluoroSpot assay was used to detect the interferon γ (IFN-γ) and interleukin 2 (IL-2) secreted by the specific T cells after being stimulated with MTB virulence factors ESAT-6 and CFP-10, MTB latency-associated antigens Rv1733c and Rv1733c SLP. The receiver operating characteristic (ROC) curve was used to define the best cutoff value of latency-associated antigens in the use of differentiating ATB and LTBI. The sensitivity, specificity, predictive value, and likelihood ratio of ESAT-6 and CFP-10-FluoroSpot combined with latency-associated antigen in the differential diagnosis of ATB and LTBI were also calculated.Results: Following the stimulation with Rv1733c and Rv1733c SLP, the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP had the largest area under the ROC curve, which was 0.766. With a cutoff value of 1 (spot-forming cells [SFCs]/2.5 × 105 peripheral blood mononuclear cells) for frequency, the sensitivity and specificity of distinguishing ATB from LTBI were 72.2% and 73.7%, respectively. ESAT-6 and CFP-10-FluoroSpot detected the frequency and proportion of single IFN-γ-secreting T cells;the sensitivity and specificity of distinguishing ATB from LTBI were 82.5% and 66.7%, respectively. Combined with the freque

关键词： Mycobacterium tuberculosis latency-associated antigens Active tuberculosis Latent tuberculosis infection Differential diagnosis

Intratumoral bacteria interact with metabolites and genetic alterations in hepatocellular carcinoma

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Signal Transduction and Targeted Therapy 2022年第10期7卷 3662-3664页

作者： Chen Xue Junjun Jia Xinyu Gu Lin Zhou Juan Lu Qiuxian Zheng Yuanshuai Su Shusen Zheng Lanjuan Li State Key Laboratory for Diagnosis and Treatment of infectious diseases National Clinical Research Center for Infectious DiseasesNational Medical Center for Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesThe First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina division of Hepatobiliary and Pancreatic Surgery Department of SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina

Dear Editor,Hepatocellular carcinoma(HCC),which ranks globally as the third leading cause of cancer-related deaths,is highly prevalent,and most patients are diagnosed with advanced-stage cancer when treatments are largely ineffective.1 Thus,there is an urgent need for earlier diagnosis to improve HCC patient outcomes.Although many types of tumors have intratumor bacteria,the tumor microbiome is poorly characterized because of limitations in the technology for detection.Recently,Nejman et al.

关键词： alterations diagnosis cancer

Non-pharmaceutical interventions for COVID-19 reduced the incidence of infectious diseases:a controlled interrupted time-series study

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infectious diseases of Poverty 2023年第2期12卷 60-71页

作者： Wenyi Zhang Yao Wu Bo Wen Yongming Zhang Yong Wang Wenwu Yin Shanhua Sun Xianyu Wei Hailong Sun Zhijie Zhang Shanshan Li Yuming Guo division of Disease Surveillance Chinese PLA Center for Disease Control and PreventionBeijing100071China School of Public Health and Preventive Medicine Monash UniversityLevel 2553 St Kilda RoadMelbourneVIC3004Australia Department of Respiratory and Critical Care Medicine China-Japan Friendship HospitalBeijing100029China division of infectious diseases Key Laboratory of Surveillance and Early-warning on Infectious DiseaseChinese Center for Disease Control and PreventionBeijing102206China Beijing Center for Disease Prevention and Control Beijing100013China Department of epidemiology and Health Statistics Fudan UniversityShanghai200032China

Background Non-pharmaceutical interventions(NPIs)have been implemented worldwide to suppress the spread of coronavirus disease 2019(COVID-19).However,few studies have evaluated the effect of NPIs on other infectious diseases and none has assessed the avoided disease burden associated with NPIs.We aimed to assess the effect of NPIs on the incidence of infectious diseases during the COVID-19 pandemic in 2020 and evaluate the health economic benefits related to the reduction in the incidence of infectious diseases.Methods Data on 10 notifiable infectious diseases across China during 2010–2020 were extracted from the China Information System for Disease Control and Prevention.A two-stage controlled interrupted time-series design with a quasi-Poisson regression model was used to examine the impact of NPIs on the incidence of infectious diseases.The analysis was first performed at the provincial-level administrative divisions(PLADs)level in China,then the PLAD-specific estimates were pooled using a random-effect meta-analysis.Results A total of 61,393,737 cases of 10 infectious diseases were identified.The implementation of NPIs was associated with 5.13 million(95%confidence interval[CI]3.45‒7.42)avoided cases and USD 1.77 billion(95%CI 1.18‒2.57)avoided hospital expenditures in 2020.There were 4.52 million(95%CI 3.00‒6.63)avoided cases for children and adolescents,corresponding to 88.2%of total avoided cases.The top leading cause of avoided burden attributable to NPIs was influenza[avoided percentage(AP):89.3%;95%CI 84.5‒92.6].Socioeconomic status and population density were effect modifiers.Conclusions NPIs for COVID-19 could effectively control the prevalence of infectious diseases,with patterns of risk varying by socioeconomic status.These findings have important implications for informing targeted strategies to prevent infectious diseases.

关键词： Non-pharmaceutical intervention infectious diseases COVID-19 Prevalence