感染性疾病是临床常见疾病,快速明确病原微生物对于指导合理治疗方案至关重要。传统的病原体检测方法耗时长、阳性率低,难以满足临床需求。宏基因组二代测序(metagenomic next-generation sequencing, mNGS)作为一种新型病原检测方法,不依赖于传统的微生物培养,也不需要特异性扩增,且其检测范围广泛,可检测细菌、病毒、真菌、寄生虫、罕见病原体,甚至未知病原体,近年来,已广泛应用于临床病原学诊断。尤其是基于血浆游离DNA (cell-free DNA, cfDNA)的mNGS检测,因其采样便捷、无创性及对全身感染的反映能力,已在临床诊断中得到了广泛的关注和应用。本文综述了血浆cfDNA mNGS在感染性疾病诊断中的临床价值、研究进展及未来展望,旨在为相关研究和临床实践提供参考。Infectious diseases are common in clinical practice, and the rapid identification of causative pathogens is crucial for guiding rational treatment strategies. Conventional microbiological tests are time-consuming and have low positivity rates, making it difficult to meet clinical needs. Metagenomic next-generation sequencing (mNGS), as an emerging pathogen detection method, does not rely on conventional microbial culture or specific amplification. With its broad detection scope, mNGS can identify bacteria, viruses, fungi, parasites, rare pathogens, and even unknown pathogens. In recent years, it has been widely applied in clinical pathogen diagnosis. In particular, plasma cell-free DNA (cfDNA) mNGS has gained significant attention and widespread clinical application due to its ease of sampling, noninvasive nature, and ability to reflect systemic infections. This review summarizes the clinical value, recent advances, and future perspectives of plasma cfDNA mNGS in the diagnosis of infectious diseases, aiming to provide insights for further research and clinical practice.
肠球菌感染最常见的部位是泌尿道,尿路感染最常见的革兰阳性细菌为肠球菌。近年来,肠球菌因其在临床上的耐药性和致病性受到越来越多的关注,尤其是耐万古霉素肠球菌出现后,肠球菌成为引发感染的第二大病原体,同时也是重要的医院获得性感染病原体之一,给患者的生命带来了威胁,同时也给肠球菌尿路感染的临床治疗带来了挑战。本文就肠球菌的病原学特征、耐药性、致病机制、肠球菌尿路感染的临床特征以及防治手段进行综述。The urinary tract is the most prevalent site for enterococcal infections, and enterococci are the most frequently encountered Gram-positive bacteria responsible for urinary tract infections. In recent years, enterococci have garnered significant attention due to their clinical resistance and pathogenic potential, especially with the emergence of vancomycin-resistant Enterococci. Enterococci have become the second leading cause of infections, as well as one of the important pathogens of hospital-acquired infections, posing a threat to patients’ lives and challenging the clinical treatment of Enterococcal urinary tract infections. This article reviews the characteristics, resistance, pathogenic mechanisms of enterococci and characteristics of enterococcal urinary tract infections, and strategies for prevention and treatment.
天疱疮是一种自身免疫性疾病,天疱疮发病率低,病情严重,如果未能得到及时有效的治疗,患者容易发生感染性休克死亡。因此对于深入理解天疱疮的发病机制而言,是至关重要的。然而目前对于天疱疮的病因机制还没有完全揭示出来。本研究从自身免疫、病毒、药物和饮食、细胞凋亡溶解等多个角度,探讨了这些因素在天疱疮的发病过程中的作用。Pemphigus is an autoimmune disease with a low incidence rate and severe condition. If not treated promptly and effectively, patients are prone to die from septic shock. Therefore, it is crucial to have a deep understanding of the pathogenesis of pemphigus. However, the etiology and mechanism of pemphigus have not been fully revealed yet. This study explores the roles of various factors such as autoimmunity, viruses, drugs and diet, and apoptosis and lysis in the pathogenesis of pemphigus from multiple perspectives.
高危型人乳头瘤病毒(HPV)感染是宫颈癌发生的主要致病因素,尤其是HPV16和HPV18型与宫颈癌的发生密切相关。本文综述了高危型HPV的流行病学特征,分析了不同地区和人群中HPV基因型的分布及其易感性差异。HPV疫苗接种和宫颈癌筛查是预防HPV感染、减少宫颈癌发生的主要策略。全球范围内HPV疫苗的推广显著降低了高危型HPV感染的流行率,对宫颈癌防治具有重要意义。此外,本文还强调了在高危人群中开展早期筛查和定期干预的重要性,突出了这些措施在促进早期诊断和减少疾病负担方面的积极作用。High-risk human papillomavirus (HPV) infection is the main cause of cervical cancer, with HPV types 16 and 18 being particularly closely linked to its development. This review explores the epidemiology of high-risk HPV, focusing on the distribution of HPV genotypes and variations in susceptibility across different regions and populations. HPV vaccination and cervical cancer screening are the primary strategies for preventing HPV infections and reducing the incidence of cervical cancer. The global expansion of HPV vaccination has significantly reduced the prevalence of high-risk HPV infections, with important implications for cervical cancer prevention and control. Furthermore, this review emphasizes the critical role of early screening and regular interventions in high-risk groups, highlighting their impact on improving early diagnosis and reducing the overall disease burden.
沙门氏菌是最常见的食源性致病菌之一,对公共卫生构成了严重威胁。近年来沙门氏菌耐药性呈上升趋势,同时多重耐药菌株的增加也给临床治疗带来了巨大困难,这已成为全球公共卫生面临的一个重大挑战。本文综述了沙门氏菌的耐药机制、耐药性的分布和趋势,以及耐药性的防控策略,旨在增强对沙门氏菌耐药性问题的认识,为控制感染、防止耐药菌的传播以及制定合适的治疗方案提供科学依据。Salmonella is one of the most common foodborne pathogens, posing a severe threat to public health. In recent years, the antimicrobial resistance of Salmonella has been increasing, and the rise in multidrug-resistant strains has also posed significant challenges to clinical treatment. This has become a major challenge facing global public health. This article reviews the mechanisms of drug resistance in Salmonella, the distribution and trends of antimicrobial resistance, and strategies for the prevention and control of antimicrobial resistance in salmonella. It aims to enhance the understanding of the issue of Salmonella resistance and provide a scientific basis for controlling infections, preventing the spread of resistant strains, and developing appropriate treatment plans.
下呼吸道感染长期以来都是全球主要导致死亡的原因之一,并且随着感染多重耐药菌患者的比例增加,快速而又准确地明确致病微生物在治疗中变得至关重要。宏基因组二代测序的出现打破了传统检测方法的局限性,它能一次性检测出标本中已知或未知的细菌、真菌及病毒,为病原微生物的检测提供了一种更全面和精准的工具。目前宏基因组二代测序已广泛运用于临床中,虽然它在使用中还面临着一些挑战和局限性,但其在感染性疾病的诊断中展现出的独特优势,使其成为一种极具潜力的技术工具。Lower respiratory tract infections have long been one of the leading causes of mortality worldwide. With the increasing proportion of patients infected with multidrug-resistant pathogens, rapidly and accurately identifying causative microorganisms has become crucial in treatment. The advent of metagenomic next-generation sequencing (mNGS) has overcome the limitations of traditional detection methods, enabling the simultaneous identification of known and unknown bacteria, fungi, and viruses in a single sample, providing a more comprehensive and precise tool for pathogen detection. Currently, mNGS has been widely applied in clinical practice. Despite facing certain challenges and limitations in its implementation, its unique advantages in diagnosing infectious diseases make it an exceptionally promising technological tool.
解脲支原体(Ureaplasma urealyticum,简称UU)作为一种重要的条件致病菌,广泛分布于人类泌尿生殖系统中,与多种感染性疾病和妊娠相关并发症密切相关,包括泌尿生殖道感染、早产、胎膜早破、支气管肺发育不良、新生儿脑膜炎及败血症等。本文将深入探讨解脲支原体的致病机制,从吸附特性、侵袭能力、免疫逃逸策略以及毒力因子等多个维度进行详细阐述。As an important conditionally pathogenic bacteria, Ureaplasma urealyticum (UU)is widely distributed in the human urogenital system and closely related to a variety of infectious diseases and pregnancy-related complications, including urogenital infections, preterm birth, premature rupture of membranes, bronchopulmonary dysplasia, neonatal meningitis and sepsis. This article delves into the pathogenic mechanisms of Ureaplasma urealyticum, providing detailed elaborations from multiple dimensions such as its adherence properties, invasive capabilities, immune evasion strategies, and virulence factors.
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