2025年 · 第05卷第02期

The Chinese Clinical Practice Guidelines for the prevention and treatment of mother-to-child transmission of hepatitis B virus, developed by the Chinese Society of Infectious Diseases of the Chinese Medical Association in 2019, serves as a valuable reference for standardizing the process of preventing mother-to-child transmission in China. As new evidence emerges, it is crucial that timely and regular updates are made to the clinical practice guidelines so as to optimize guidance for clinical practice and research. To this end, the Infectious Disease Physician Branch of Chinese Medical Doctor Association and the Chinese Society of Infectious Diseases of Chinese Medical Association, in collaboration with multidisciplinary experts, have updated the guidelines based on the latest domestic and international research advancements and clinical practice, in order to provide guidance and reference for clinicians and maternal and child healthcare workers. Guideline registration: International Practice Guidelines Registry Platform (PREPARE-2023CN171).

The resurgence of pertussis in China has recently attracted much attention. The incidence and burden of pertussis are largely underestimated in China owing to the lack of active pertussis surveillance and insufficient laboratory diagnosis. The high prevalence of macrolide-resistant Bordetella pertussis imposes a major challenge for the management of pertussis cases. To address a series of practice issues regarding pertussis diagnosis, treatment, and prevention, especially immunization practices, a multidisciplinary guideline development group (GDG) consisting of experts in the fields of infectious diseases, pediatric critical care medicine, clinical microbiology, epidemiology, and immunization planning jointly developed the first clinical practice guidelines for pertussis in China. Utilizing the Grading of Recommendations Assessment, Development and Evaluation Evidence-to-Decision framework recommended by the World Health Organization, the GDG formulated corresponding recommendations and suggestions. Good Practice Statements were created for issues not suitable for conventional evidence rating through the presentation of evidence and expert experience. The implementation suggestions for the 12 priority clinical questions given in this paper fully considered Chinese and international experiences as well as the national situation and policy. The primary target audience of these guidelines includes clinicians, microbiology laboratory staff, public health professionals, and policymakers.

Background: The coronavirus disease 2019 (COVID-19) pandemic has resulted in a dynamic evolution of the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), initially characterized by primary responses and later by secondary responses due to mass vaccination and viral variants. Understanding the interplay between humoral (antibody) and cellular (T-cell) immunity is crucial for effective public health strategies. This study aims to evaluate the correlation between T-cell responses and antibody levels in a sample of the adult Albanian population during the transition of COVID-19 from a pandemic to an endemic phase. The rationale for this investigation is to generate data that can inform the ongoing management of COVID-19, particularly in the context of vaccination and immunity monitoring, to ensure that public health strategies remain effective as the virus becomes more permanent in the population. Methods: This cross-sectional observational study involved individuals over 18 years of age who were randomly selected at intervals of every 20 records from the family doctor registries of five urban health centers in Tirana and Berat, Albania, between January 23 and April 3, 2023. Participants provided demographic and health data, including vaccination and infection history. Blood samples were analyzed for cellular immunity using an Interferon-gamma (IFN-γ) release assay and for humoral immunity using the enzyme-linked immunosorbent assay to measure anti-spike (S1) and anti-nucleoprotein (N) IgG antibodies. Statistical analyses were conducted to examine the relationships between levels of IFN-γ, anti-S1, and anti-N IgG antibodies and factors such as vaccination status, prior COVID-19 infections, and reinfection rates. These analyses employed bivariate and multivariate approaches, including Fisher’s exact test, the Mann-Whitney U test, the Kruskal-Wallis test, linear and multiple regression analyses, and Spearman’s correlation coefficient test. Results: The study involved 164 individuals (54.7% [90/164] female, median age 43 years). Of these individuals, 62.8% (103/164) were vaccinated, primarily with the Pfizer-BioNTech vaccine. IFN-γ positivity was detected in 95.1% (156/164), and anti-S1 IgG positivity in 93.3% (153/164). Significant correlations were observed between IFN-γ and anti-S1 IgG levels (r = 0.502; P < 0.001). Vaccinated individuals exhibited significantly higher levels of IFN-γ and anti-S1 IgG than unvaccinated individuals (P < 0.05). Reinfections were more prevalent in unvaccinated individuals than vaccinated individuals (26.2% [16/61] vs. 12.6% [13/103], P = 0.034). According to multiple regression analysis, the levels of anti-S1 antibodies were significantly correlated with protection against reinfection (regression coefficient β = -0.003; P = 0.042), while IFN-γ levels did not exhibit such a correlation (regression coefficient β = -1.659; P = 0.146). Conclusion: Vaccination, especially when combined with previous infection, significantly boosts both cellular and humoral immunity against SARS-CoV-2. The close correlation between IFN-γ and anti-S1 IgG levels indicates that vaccinated individuals mount a robust immune response. The lower reinfection rates among vaccinated individuals highlight the importance of vaccination for sustained protection. Assessing anti-S1 IgG antibodies and IFN-γ levels could be particularly beneficial for immunocompromised individuals when making decisions about revaccination. This study highlights the critical role of comprehensive immune monitoring in the management of COVID-19 and offers insights for future vaccination strategies.

Background: The emergence of antibiotic resistance, particularly plasmid-mediated colistin resistance, poses a critical threat to global public health, given colistin’s role as a last-resort antibiotic for treating multidrug-resistant (MDR) bacterial infections. Despite its significance, data on colistin resistance and the prevalence of mobile colistin resistance (mcr) genes in Nepal are scarce. This study aims to investigate the occurrence of plasmid-mediated mobilized colistin resistance genes mcr-1 and mcr-2 in MDR Escherichia coli isolates from clinical specimens, highlighting the burden of resistance and its clinical implications in Nepalese context. Methods: A hospital-based cross-sectional study was conducted at Sukraraj Tropical Infectious Disease Hospital in Kathmandu from March to August 2022. A total of 1358 clinical specimens were processed using standard microbiological techniques. Antibiotic susceptibility testing followed the Kirby-Bauer disk diffusion method per the 2016 Clinical and Laboratory Standards Institute guidelines. The minimum inhibitory concentration (MIC) for colistin was determined via agar dilution method. Colistin-resistant strains were further investigated for the detection of mcr-1 and mcr-2 genes using endpoint polymerase chain reaction. Results: A total of 86 E. coli isolates were recovered with a prevalence rate of 6.3% (86/1358). Higher growth rates of E. coli were observed among females (9.0%, 56/620), individuals aged 46-60 years (8.5%, 23/271), and in pus samples (3 out of 7). Majorities of the isolates exhibited high resistance rates towards beta-lactam antibiotics and cotrimoxazole, with 81.4% (70/86) classified as MDR. The MIC of colistin was ≥ 4 μg/mL in 7 isolates. The prevalence of extended-spectrum beta-lactamase (ESBL)-, metallo-beta-lactamase (MBL)-, and klebsiella pneumoniae carbapenemases-producing isolates was 40.7% (35/86), 14.0% (12/86), and 1.2% (1/86), respectively. The mcr-1 gene was detected in 5 colistin-resistant isolates, while mcr-2 was not identified. Notably, all ESBL- and MBL-producing isolates were also MDR, with higher proportions of ESBL-producing (4 out of 5) and MBL-producing (1 out of 5) strains among those harboring the mcr-1 gene. Conclusions: This study highlights a concerning prevalence of mcr-1-mediated colistin resistance in E. coli isolates, compounded by co-resistance to other critical antibiotics such as beta-lactams and carbapenems. The findings underscore the urgent need for enhanced surveillance, antimicrobial stewardship, and research into colistin resistance mechanisms for preventing further escalation of the resistance burden.

A member of the tripartite-motif (TRIM) protein family of E3 ligases, TRIM56 has increasingly been recognized as a versatile player in innate antiviral immunity that operates via catalytically-dependent and catalytically-independent mechanisms. Herein, we provide a concise overview of the various roles that TRIM56 has been demonstrated to play in host interactions with viruses, including its "direct" virus-restricting activities and "indirect" antiviral effects resulting from its positive regulation of innate immune signaling. In addition, we discuss the current understanding of the molecular determinants and underlying biology by which TRIM56 functions in these processes.

The clustered regularly interspaced short palindromic repeat (CRISPR)-Caspase (Cas) system acts as a natural defense of bacteria against invasion by mobile genetic elements, such as plasmids, transposons, and bacteriophages. The review discusses the different classes and types of CRISPR-Cas systems in terms of principles of their action, limitations, and future perspectives. Also, the role of the CRISPR-Cas system as a new arsenal in fighting multidrug-resistant pathogens and clinically relevant pathogenic viruses and up-to-date clinical trials have been discussed and highlighted. Moreover, the utilization mode, regulation, and the link of CRISPR-Cas to quorum sensing for targeting cell chromosome or antimicrobial-resistant gene(s) of some clinically relevant pathogens, including Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa have been discussed. The information provided in this review can act as a platform for researchers for the future use of the CRISPR-Cas system as a smart antimicrobial agent for combating infections caused by life-threatening pathogens, particularly those with limited therapeutic options.

Omsk hemorrhagic fever virus (OHFV) is a tick-borne flavivirus associated with acute febrile illness and hemorrhagic disease in humans. OHFV was first identified in 1947 and since its identification has largely remained endemic to the Omsk region of the Russian Federation, where it continues to result in illnesses each year. However, the 2 primary tick vectors of OHFV exhibit ranges that extend far beyond the Omsk region, and the recent positive confirmation of OHFV in samples outside of the historic endemic range, in both the Russian Federation and neighboring Kazakhstan, to the south raises new concerns about the future potential of the pathogen. In this review, we comprehensively discuss the emergence, virology, ecology, and disease of OHFV.