Jul 2026· Problems of Particularly Dangerous Infections· pp. 70-77· 0 citations· 8 references
TL;DR
It is necessary to increase the alertness of medical personnel, incorporate melioidosis in the differential diagnostics of community-acquired pneumonia in people with a “traveler’s history”, maintain the readiness of specialized laboratories, strengthen awareness-raising among the population traveling to regions endemic for dangerous infectious diseases, and ensure effective interdepartmental cooperation.
Abstract
In 2024, two cases of community-acquired pneumonia (CAP) imported from Thailand were registered and etiologically deciphered in the Irkutsk Region, including the first case of acute melioidosis resulting in death, which was diagnosed for the first time in the Russian Federation. In the second case,
Acinetobacter radioresistens
was isolated from a patient with CAP.
The aim
of the work was to conduct indication and species identification of pathogens causing community-acquired pneumonia, obtained from biological material from patients who had arrived from Thailand to the Irkutsk Region.
Materials and methods
. The culture of a microorganism isolated from a liver sample of a patient with the fatal outcome, preliminarily identified by mass spectrometry as a causative agent of the genus
Burkholderia
and clinical material (blood, throat swab, sputum, urine) from a patient with suspected melioidosis were studied. The research was performed using bacteriological, bacterioscopic, molecular-genetic, proteomic, and serological methods of laboratory diagnostics.
Results and discussion
. In the first imported case, a culture of
Burkholderia pseudomallei
was isolated from a patient with a postmortem clinical diagnosis of community-acquired bipartite pneumonia; rapid identification of the causative agent of melioidosis was carried out using MALDI-TOF MS and PCR methods. For the purpose of in-depth identification, the isolated culture was studied by a range of laboratory diagnostic methods for melioidosis. The sensitivity of the isolated
B. pseudomallei
strain to some first- and second-line antibacterial drugs was established, and its species resistance to penicillins, aminoglycosides, and macrolides was confirmed. In the second imported case of community-acquired pneumonia, the causative agent of melioidosis and its DNA were not found in the patient’s clinical material. A culture was isolated from the patient’s urine sample, which was identified by mass spectrometry as
Acinetobacter radioresistens
. In view of the growing number of imported cases of exotic infections in the Russian Federation, including melioidosis, it is necessary to increase the alertness of medical personnel, incorporate melioidosis in the differential diagnostics of community-acquired pneumonia in people with a “traveler’s history”, maintain the readiness of specialized laboratories, strengthen awareness-raising among the population traveling to regions endemic for dangerous infectious diseases, and ensure effective interdepartmental cooperation within the framework of sanitary protection of the territory of Russia in order to establish an etiological diagnosis of community-acquired pneumonia and correct treatment scheme.
Community-acquired pneumonia in children remains one of the leading infectious causes of mortality, its etiological structure is constantly changing. A high proportion of pneumonias with an unspecified pathogen is characteristic of the Republic of Belarus that complicates the rational selection of initial therapy and contributes to the growth of antibiotic resistance.A retrospective cohort study of 485 clinical records of children aged 0 to 17 years with confirmed community-acquired pneumonia was conducted. Bacteriological culture, polymerase chain reaction (PCR) of respiratory tract samples, and enzyme-linked immunosorbent assay (ELISA) for IgM/IgG antibodies to M. pneumoniae and C. pneumoniae were used for etiologic diagnosis.In 64,9% of cases, the etiology was not identified. Among cases with an established etiology, respiratory viruses predominated in children under 5 years of age (60,9%), Mycoplasma pneumoniae predominated in children aged 10 years and older (78,3%), while in the 5–9 years ago group, no single pathogen showed a clear predominance (M. pneumoniae — 48,1%, respiratory viruses — 29,6%, typical bacteria and mixed infections — 11,1% respectively).The identified age-related pattern, combined with the high proportion of cases with unidentified etiology, allows the proposal of three clinical-therapeutic strategies. In children under 5 years of age, antibiotic use should be limited in the absence of firm indications. In children aged 10–17 years, macrolides are the preferred choice for initial therapy. In the 5–9 years age group, diagnostic investigation is necessary, including mandatory assessment of inflammatory biomarkers and pathogen verification.
E. O. Shcheglova, E. Kozorez, V. M. Mitsura et al.· Medical and Biological Probl...· 0 citations
Summary Background Disease caused by nontuberculous mycobacteria (NTM) is often misdiagnosed as tuberculosis (TB) in India. Comprehensive studies on NTM are lacking, therefore, the present study aimed to describe clinical features, underlying conditions, species distribution, and treatment outcomes of NTM disease among people with presumptive TB (individuals with symptoms suggestive of TB) in India. Methods This prospective study (2021–2025) was conducted across seven tertiary care centres in India. People older than or equal to 12 years, irrespective of their human immunodeficiency virus status, diagnosed with NTM disease were included. Individuals with concurrent TB were excluded. Participants were recruited consecutively from individuals with presumptive pulmonary TB (PTB) and extrapulmonary TB at participating centres. Clinical, radiological, and laboratory data were collected from study centres under supervision of dedicated clinicians. Line probe assay (LPA) and Whole-genome sequencing (WGS) were used for NTM diagnosis. Recent guideline-based treatment (GBT) was administered to people diagnosed with NTM disease. Main outcomes of this study included clinical and radiological characteristics, species distribution, and treatment outcomes of NTM pulmonary disease (NTM-PD) and extrapulmonary NTM (EP-NTM) disease. Findings Among 71,143 individuals with presumptive TB, 230 (0·32%) had NTM disease (191 pulmonary and 39 extrapulmonary). In NTM-PD, common underlying conditions included previous PTB (80·6%), malnutrition (47·1%), and vitamin D deficiency (43·5%). M. avium complex (25·7%), M. abscessus complex (24·3%), and M. kansasii (20·9%) were the most frequently isolated NTM species. LPA and WGS showed 97·6% concordance in diagnosing NTM. Of 155 individuals with NTM disease with complete treatment details, 137 (88·4%) completed therapy; mean culture conversion time was 94·3 days for NTM-PD. Poor treatment outcome (9 deaths, 9 lost to follow-up) was noted in 18/155 (11·6%) treated individuals. Interpretation NTM disease among people with presumptive TB is an emerging public health problem in India. Integrating rapid molecular diagnostic tests for early diagnosis and GBT into National Tuberculosis Programmes is essential to improve outcomes by reducing diagnostic and treatment delays. Funding Indian Council of Medical Research.
S. K. Sharma, V. Upadhyay, A. Mohan et al.· The Lancet Regional Health -...· 0 citations
BACKGROUND
Non-typhoidal Salmonella (NTS) causes illnesses ranging from gastroenteritis to invasive bloodstream infection, particularly in vulnerable hosts. We describe the clinical profile and antimicrobial susceptibility of NTS isolates recovered at a tertiary-care hospital in Navi Mumbai.
METHODS
We conducted a retrospective case series of consecutive NTS isolates recovered from blood and stool between January 2022 and December 2025. Identification and MIC-based susceptibility testing were performed using automated platforms; azithromycin and chloramphenicol were tested by gradient diffusion or disc diffusion. Results were interpreted according to CLSI M100.
RESULTS
Eighteen isolates were recovered from 17 patients (15 blood and 3 stool). The median age of patients with invasive infection was 57 years (range, 0.5-84). Among adults with invasive NTS (n=12), 11 (91.7%) had comorbidities. Three invasive cases occurred in children aged 6 months to 2 years; one had a structural urinary tract abnormality. Among invasive cases, 7/15 (46.7%) required intensive care, 3/15 (20.0%) developed septic shock, and 5/15 (33.3%) developed acute kidney injury. No in-hospital mortality occurred; one late death was unrelated to the index episode. Ciprofloxacin non-susceptibility occurred in 6/15 (40.0%) blood isolates, comprising 2 intermediate and 4 resistant isolates; one of three stool isolates was intermediate. One blood isolate was ceftriaxone-resistant with a presumptive ESBL phenotype detected by VITEK 2 AES. All isolates were susceptible to meropenem and trimethoprim-sulfamethoxazole. All tested isolates were susceptible to chloramphenicol (15/15). Azithromycin results (15/15) fell within the susceptible range using S. Typhi criteria because NTS-specific CLSI breakpoints are unavailable.
CONCLUSIONS
In this small single-centre series, most adults with invasive NTS had comorbidities, and bloodstream infections were frequently severe. Ciprofloxacin non-susceptibility and a ceftriaxone-resistant isolate with a presumptive ESBL phenotype support culture-guided therapy, local antibiogram review, antimicrobial stewardship, and continued surveillance.
Jyoti Prakash Panda, Narendra Patil, Sana Rahmani et al.· Indian Journal of Medical Mi...· 0 citations
BACKGROUND
Mycoplasma pneumoniae is a leading cause of pediatric community-acquired pneumonia. Macrolide-resistant M. pneumoniae (MRMP) emerged in East Asia in the 2000s and was once highly prevalent in Japan. However, its epidemiology in Japan following the coronavirus disease 2019 (COVID-19) pandemic is unclear.
METHODS
The present, single-center, retrospective study, conducted at a tertiary children's hospital in Tokyo, investigated the post-pandemic prevalence of MRMP and compared the clinical features of MRMP and macrolide-susceptible M. pneumoniae (MSMP). Patients aged ≤ 18 years who were positive for M. pneumoniae on polymerase chain reaction (PCR) between April 2020 and March 2025 were enrolled. MRMP was defined by macrolide-resistance mutations detected using a point-of-care, PCR-based assay. The proportion of patients with MRMP and the clinical characteristics of the MRMP and MSMP cohorts were analyzed.
RESULTS
In total, 272 patients had a M. pneumoniae infection, and 191 (70.2%) patients were classified into the MRMP group. A marked resurgence of M. pneumoniae infections, of which MRMP comprised 87% of the cases, was observed in April 2024 and peaked in October 2024. Among hospitalized patient (52/272, 19.1%), MRMP group were more likely to require oxygen (89% vs. 43%, p = 0.0015), and experience respiratory complications (47% vs. 7.1%, p = 0.019) than MSMP group.
CONCLUSION
MRMP reemerged as the predominant strain in Tokyo following the COVID-19 pandemic and may be associated with greater severity and recalcitrance to treatment. Therefore, monitoring its prevalence and adjusting the antibiotic strategy are crucial.
Natsuki Koriyama, Yo Murata, Shoichiro Shirane et al.· Pediatrics International· 0 citations
Clinicians should maintain a high index of suspicion in patients presenting with severe pneumonia or sepsis, particularly during the rainy season and among individuals with diabetes mellitus or chronic liver disease, and strengthening conventional microbiological capacity remains essential for improving diagnosis and patient outcomes in geographically isolated settings.
Duy-Cuong Le, Dinh-Dung Nguyen, T. Nguyen et al.· BMC Infectious Diseases· 0 citations
Introduction. Community-acquired pneumonia (CAP) remains a significant health problem requiring attention due to its high prevalence and difficulties in etiological diagnosis.The purpose is to study the epidemic process of CAP in the Lipetsk region over 2011–2024. and assessing the relationship with the incidence of influenza and acute respiratory viral infections.Materials and methods. Analytical, logical, epidemiological, and statistical methods were used. Data from federal statistical reporting forms No. 1 and No. 2 of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor) for 2011–2024, calculated per 100 thousand population, were used. Statistical processing was carried out using variation statistics methods in Microsoft Excel (2010). Correlation was assessed using the Spearman coefficient.Results. The CAP incidence in the total population of the region increased by1.7 times (from 450.5 per 100 thousand in 2011 to 800.8 in 2024); the long-term average was 604.23. The maximum was recorded in 2020 (1194.78). The correlation of CAP with influenza and ARVI was weak and statistically insignificant. The structure of morbidity was dominated by adults (70.3%), among children — groups of 7–14 years (32.2%) and 3–6 years (26.3%). In 2023, there was an increase associated with the circulation of Mycoplasma pneumoniae. Before the pandemic, M. pneumoniae and other bacteria predominated; in 2020–2022 SARS-CoV-2 dominated; Since 2023, bacterial agents have become active again. About 50% of cases remained etiologically undeciphered (in 2024 — 72%).Limitations. When studying the CAP incidence in the Lipetsk region, an analysis of data from official statistical reporting forms No. 1 and No. 2 “Information on infectious and parasitic diseases” of Rospotrebnadzor for 2011–2024 for the Lipetsk region was carried out.Conclusions. The epidemiological situation regarding CAP in the region remains unstable. It is necessary to improve diagnostics with the introduction of modern laboratory methods and increase the level of etiological decoding to optimize prevention and reduce mortality.Compliance with ethical standards: the study does not require the submission of the conclusion of the biomedical ethics committee or other documents.Contribution of the authors: Korotkova T.S. — The concept and design of the study, writing text, compiling a list of literature; Trukhina G.M. — editing, approval of the final version of the article; Reshetova A.A. — collection and processing of material, writing text, statistical processing, compiling a list of literature; Savelyev S.I. — editing, approval of the final version of the article, responsibility for the integrity of all parts of the article; Tabolina E.Yu. — statistical processing of material, editing; Ushakov S.A. — approval of the final version of the article, responsibility for the integrity of all parts of the article. All co-authors approved the final version of the article.Funding. The study did not have sponsorship.Conflict of interests. The authors declare the absence of a conflict of interest.Received: October 6, 2025 / Accepted: April 24, 2026 / Published: July 28, 2026
Tatiana Korotkova, Galina M. Truchina, A. Reshetova et al.· Health Care of the Russian F...· 0 citations
