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Sharma S, Krishnaswamy V, Chaturvedi R, Sharma A. Epidemiology of rare bacterial, parasitic, and fungal pathogens in India. IJID REGIONS 2024; 11:100359. [PMID: 38646508 PMCID: PMC11026704 DOI: 10.1016/j.ijregi.2024.100359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024]
Abstract
Rare human pathogens are infrequently observed clinically but can lead to undiagnosed infections, delays in treatment, severe complications, including death. Traditional diagnostic tools cannot routinely detect rare infections in public health settings. This study focuses on the incidence and outcomes of rare pathogenic microorganisms over 13 years (2010-2022) using PubMed database to obtain epidemiological data on rare bacterial, parasitic, and fungal infections in hospitals throughout India. A total of 974 articles were screened using case studies, datasets, comments, classical articles, letters, editorials, observational studies, and meta-analyses. Our analysis identified 28 rare bacteria, six parasites, and five fungal species infections in India. Fatal cases were associated with rare bacterial and fungal infections, including two from pan-drug-resistant bacteria (both from the Myroides genus). A total of 10 bacterial species displayed multi-drug resistance; one was extensively drug-resistant, and eight remained unclassified. Of the 83 patients with these rare infections, the mortality was ∼8.4% (seven of 83). Considering drug resistance and high mortality, prompt diagnosis of rare pathogens is crucial to controlling their spread. An increased awareness within the Indian health care system focusing on diagnostics, record keeping, and data sharing will be necessary to enhance surveillance.
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Affiliation(s)
- Shweta Sharma
- Molecular Medicine Division, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
- ICMR-National Institute of Malaria Research, New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Varun Krishnaswamy
- Molecular Medicine Division, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Rini Chaturvedi
- Molecular Medicine Division, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Sharma
- Molecular Medicine Division, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
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Wang J, Zhang H, Ji X, An P. Tumor-like concurrent pulmonary and cerebral infection caused by Nocardia farcinicas. Asian J Surg 2024:S1015-9584(24)00492-5. [PMID: 38519316 DOI: 10.1016/j.asjsur.2024.03.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/08/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024] Open
Affiliation(s)
- Jingxian Wang
- Department of Radiology and Neurology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China; Department of Internal Medicine and Oncology, Hubei Province Clinical Research Center of Parkinson's Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, P.R.C, Xiangyang, Hubei Province, 441000, China
| | - Haidong Zhang
- Department of Internal Medicine and Oncology, Hubei Province Clinical Research Center of Parkinson's Disease, Xiangyang Key Laboratory of Movement Disorders, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Hubei, P.R.C, Xiangyang, Hubei Province, 441000, China
| | - Xianqun Ji
- Department of Radiology and Neurology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China; Department of Stomatology and Orthopedics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China.
| | - Peng An
- Department of Radiology and Neurology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China; Department of Stomatology and Orthopedics, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, 441000, China.
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Jin S, Guo X, Xing H, Li D, Wang Y, Ma W. Multiple brain abscesses caused by Nocardia asiatica: Case report and literature review. IDCases 2023; 34:e01903. [PMID: 37928816 PMCID: PMC10622833 DOI: 10.1016/j.idcr.2023.e01903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
Nocardia are opportunistic pathogens mainly affecting immunocompromised individuals. Nocardia asiatica, a novel species, can cause severe infections. We present a case of multiple brain abscesses due to Nocardia asiatica, discussing its diagnosis and treatment. In January 2022, a 27-year-old Chinese woman with a history of atypical membranous nephropathy presented with low-grade fever, cough, limb weakness, and headaches. Imaging revealed lung and brain lesions. Neurological symptoms worsened over time, culminating in recurrent seizures and severe headaches. A brain MRI confirmed multiple abscesses. Craniotomy and lesion removal were performed, leading to a diagnosis of brain abscesses caused by Nocardia asiatica. Empirical antibiotics were followed by targeted regimen. After successful treatment, the patient remained symptom-free during follow-ups. Nocardia asiatica multiple brain abscesses are exceedingly rare. This case underscores the importance of considering nocardiosis in immunosuppressed patients presenting with neurological symptoms. Timely neurosurgical intervention and effective antibiotic therapy are crucial. Metagenomic next-generation sequencing proved invaluable for rapid diagnosis. Treatment with trimethoprim-sulfamethoxazole (TMP-SMX) and a carbapenem followed by TMP-SMX alone achieved disease control. This case contributes to the understanding of Nocardia asiatica infections and highlights the role of neurosurgical procedures in managing disseminated nocardiosis.
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Affiliation(s)
- Shanmu Jin
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
- 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaopeng Guo
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hao Xing
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Dingding Li
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yu Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Wenbin Ma
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Hayashi Y, Kitajima T, Marumo S, Fukui M. Adult T Cell Leukemia/Lymphoma Becoming Apparent during Treatment of Pulmonary Abscess and Empyema Caused by Nocardia asiatica: A Case Report and Review of the Literature. Intern Med 2022; 61:2227-2232. [PMID: 34980794 PMCID: PMC9381332 DOI: 10.2169/internalmedicine.8428-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Nocardia is a Gram-positive bacterium that causes opportunistic infections. Nocardia asiatica was newly isolated in 2004, and there have been no case reports describing the empyema caused by N. asiatica. Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell malignancy caused by human T-cell leukemia virus type 1 (HTLV-1). We herein report a case in which immunosuppression attributable to ATL may have led to pulmonary abscess and empyema caused by N. asiatica. Our case demonstrates the need to investigate causes of immunosuppression, including ATL, in patients showing nocardiosis.
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Affiliation(s)
- Yusuke Hayashi
- Department of Respirology, Kitano Hospital, the Tazuke Kofukai Medical Research Institute, Japan
| | - Takamasa Kitajima
- Department of Respirology, Kitano Hospital, the Tazuke Kofukai Medical Research Institute, Japan
| | - Satoshi Marumo
- Department of Respirology, Kitano Hospital, the Tazuke Kofukai Medical Research Institute, Japan
| | - Motonari Fukui
- Department of Respirology, Kitano Hospital, the Tazuke Kofukai Medical Research Institute, Japan
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Arora H, Ramalingam S, Sanghavi R, Balogun A, Muruganandam M. Disseminated Nocardia infection-A rare presentation. Clin Case Rep 2021; 9:e04673. [PMID: 34457292 PMCID: PMC8380077 DOI: 10.1002/ccr3.4673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/02/2021] [Accepted: 07/11/2021] [Indexed: 11/22/2022] Open
Abstract
Nocardia infection is rare and requires early diagnosis, extended use of sulfonamides for good prognosis, and prevention of recurrence. It is crucial to suspect nocardiosis in cases of atypical pneumonias or unexplained visceral organ dysfunction.
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Al-Mozaini M, Alrahbeni T, Dirar Q, Alotibi J, Alrajhi A. HIV in the Kingdom of Saudi Arabia: Can We Change the Way We Deal with Co-Infections. Infect Drug Resist 2021; 14:111-117. [PMID: 33500633 PMCID: PMC7822075 DOI: 10.2147/idr.s270355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/07/2020] [Indexed: 12/21/2022] Open
Abstract
The first incidence of acquired immunodeficiency syndrome (AIDS) from the Kingdom of Saudi Arabia (KSA) was reported back in 1984, and by the end of 2013, around 1509 patients were diagnosed with HIV infection. Recently in 2018, the Saudi ministry of health released that the incidence of HIV in Saudi Arabia is 3 cases of HIV for every 10,000 of the population. Having said that, the surveillance of HIV will face a range of challenges in KSA despite proper medical care, counseling, family planning, diagnostic, evaluation, and the use of effective anti-retroviral therapy. Patients who underwent anti-retroviral therapy showed significant reduction in morbidity as well as mortality. On the other hand, further targeted treatment and preventive strategies are warranted to control HIV co-infections in the KSA. In addition, progress towards meeting the WHO 90-90-90 goals for HIV not only at KSA but at the MENA region too, which is that of the population, 90% are diagnosed, 90% undergoing treatment, and 90% under viral control, is not being systematically monitored. In this review, we discuss the common co-infections with HIV infections that are reported in KSA, which when compared to international trends, it is similar for both viral hepatitis and tuberculosis. Although those co-infections exist, they are presented in different ratios and percentages when compared to the international reported data. These differences mandates defining and introducing new resilient methods of treatment and preventive measures. In this review, we offer an insight into healthcare policymakers to be compliant with UNAIDS 2020 vision program. We also discuss some of the gaps and recommendations to achieve the WHO 90-90-90 goal.
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Affiliation(s)
- Maha Al-Mozaini
- Immunocompromised Host Research Section, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - Qais Dirar
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Jawaher Alotibi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdulrahman Alrajhi
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Mu YZ, Liu Y, Wang YJ, Zhang ZZ. A case report and review of lymphocutaneous nocardiosis caused by Nocardia brasiliensis reported in China. Dermatol Ther 2019; 32:e13001. [PMID: 31216085 DOI: 10.1111/dth.13001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 06/06/2019] [Accepted: 06/17/2019] [Indexed: 12/14/2022]
Abstract
Primary cutaneous nocardiosis caused by Nocardia brasiliensis is an uncommon disease. The present authors report a Chinese woman presented with lymphocutaneous nocardiosis caused by N. brasiliensis. The lesion begin with her right hand after an unknown insect sting and evolved rapidly and formed painful erythema and two subcutaneous nodules and abscesses on her right forearm in 5 days. N. brasiliensis was isolated from pustule and identified by gene sequencing. The patient received 2 weeks of combination therapy contained infusion of amoxilin potassioum clavinet and oral TMP/SMX and followed by a single therapy of oral TMP/SMX for 1 month and got a marked improvement. The present authors reviewed a case of lymphocutaneous nocardiosis caused by N. brasiliensis reported in China.
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Affiliation(s)
- Yun-Zhu Mu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ying- Liu
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yu-Juan Wang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zheng-Zhong Zhang
- Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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