Evaluation of the JF5-based Aspergillus galactomannoprotein lateral flow device for diagnosing invasive aspergillosis in cancer patients.

PURPOSE: Cancer patients are at heightened risk for invasive aspergillosis (IA), a condition associated with elevated mortality risk. The JF5-based Aspergillus Galactomannoprotein Lateral Flow Device (AspLFD) offers rapid point-of-care testing (POCT) for IA. This study evaluated the diagnostic performance of AspLFD in cancer populations. METHODS: This retrospective study examined cancer patient bronchoalveolar lavage fluid (BALF) and serum samples collected between September 2021 and January 2023. Both AspLFD and galactomannan (GM) assays were conducted, and the results were analysed by two independent researchers. RESULTS: This study included 242 samples from 218 cancer patients, with 58 BALF and 184 serum samples. The overall agreement between AspLFD and GM assay results was 92.1%, with a kappa value of 0.552. AspLFD diagnosed proven/probable IA with a sensitivity and specificity of 91.7% and 95.3%, respectively, whereas GM exhibited sensitivity and specificity values of 83.3% and 93.7%, respectively. There were no statistical differences in the sensitivity and specificity between the two methods (P > 0.05). For serum analyses, AspLFD and GM exhibited similar sensitivity (66.7% vs. 66.7%, P > 0.05) and specificity (98.6% vs. 96.6%, P > 0.05) values. However, the sensitivity of the AspLFD was superior to the GM assay (100% vs. 88.9%) in BALF analyses but the difference was not statistically significant (P > 0.05), with no difference in specificity (83.7% vs. 83.7%, P > 0.05). In the solid-tumour cohort, both the AspLFD and GM assay exhibited high sensitivity (100% for both) and specificity (94.2% vs. 92.8%, P > 0.05). CONCLUSION: The AspLFD demonstrated good performance in diagnosing IA in cancer patients, especially those with solid tumours. The AspLFD is thus an alternative POCT, particularly when GM evaluations are not readily available.

Insights into mucoid Acinetobacter baumannii: A review of microbiological characteristics, virulence, and pathogenic mechanisms in a threatening nosocomial pathogen.

Acinetobacter baumannii (A. baumannii) is an opportunistic pathogen and leading cause of health care-associated infections. Several known pathogenic factors, including lipopolysaccharide, capsular polysaccharides, phospholipase, protein secretion systems, two component efflux pumps and biofilm formation, are associated with the bacteria. However, owing to the new biological characteristics rapidly developed under the external stress, the pathogenesis becomes complicated. The formation of mucoid phenotype is a major adaptive defense response for A. baumannii. The mucus is mainly comprised of capsular polysaccharide, which forms a barrier around the bacterial cell wall, and provides protection from environmental pressures and host immune responses. Importantly, mucoid formation has been shown to confer changes in the pathogenicity and pathogenesis of A. baumannii. Thus, this review aims to highlight the biological characteristics, virulence and underlying pathogenic mechanisms of mucoid A. baumannii. We primarily provide profound insight into the structure, function and detecting methods of the mucus in mucoid A. baumannii. Then we mainly illustrate the current studies on mucoid A. baumannii. Finally, the unsolved areas associated with mucoid A. baumannii are summarized. In summary, this review will critically offer a comprehensive understanding of mucoid A. baumannii and provide novel insight into the diagnosis and intervention strategies for the increasingly deadly human pathogen.

Acquired mucoid phenotype of Acinetobacter baumannii: Impact for the molecular characteristics and virulence.

Mucoid phenotype is an important adaptive defense response for Acinetobacter baumannii (A. baumannii). The aim of this study was to analyze the impact of mucoid phenotype for the molecular characteristics and virulence of A. baumannii. We observed that the colonies of mucoid A. baumannii were moist, with an elevated surface, and the wire drawing result was positive. Transmission electron microscopy data showed that the outer wall of the mucoid colonies was not smooth, had protruding pseudopodia, and was surrounded by a layer of unknown material. Antibiotic susceptibility testing showed that the mucoid strains were multidrug resistant. Notably, the mucoid phenotype and antibiotic resistance were not correlated with the amount of biofilm produced by A. baumannii. MLST data demonstrated that the mucoid A. baumannii strains belonged to type ST2. Most (82.6 %, 38/46) of the multidrug-resistant nonmucoid strains also belonged to the molecular type ST2 and to other types, including ST129, ST158, ST195, ST80 and ST3. Moreover, mucoid A. baumannii strains were more virulent than nonmucoid isolates in a mouse model. The comparative transcriptomic data indicated that 15 genes, especially IX87_RS16955 (acnA), IX87_RS10800 (XanP), IX87_RS12875 (GlmM), IX87_RS00885 and IX87_RS12395 (bfr), were possibly associated with the phenotype and virulence of mucoid A. baumannii. In conclusions, the study comprehensively describes the molecular characteristics and virulence regulatory mechanism of mucoid A. baumannii, and provides novel insights for the prevention and treatment of infections associated with these strains.

Bacteremia Caused by Turicella otitidis in a Patient with Diffuse Large B-Cell Lymphoma.

BACKGROUND: Invasive Gram-positive bacilli infections are commonly encountered in immunocompromised patients. In this paper, we report a bacteremia caused by Turicella otitidis in a patient with diffuse large B-cell lymphoma. METHODS: Bacteria was identified by VITEK MALDI-TOF MS. Drug sensitivity was analyzed by disk diffusion method. RESULTS: MALDI-TOF MS data demonstrated that the infection bacteria was Turicella otitidis. Drug susceptibility data showed that Turicella otitidis was possibly sensitive to vancomycin, polymyxin B, and chloramphenicol. Body temperature of the patient dropped after administration of vancomycin. The data indicated that vancomycin could be used to treat the infections caused by Turicella otitidis. CONCLUSIONS: MALDI-TOF MS can be used for the rapid and accurate identification of Turicella otitidis. Vancomycin can be used to treat the infection caused by Turicella otitidis. This study may provide a reference for the diagnosis and treatment of Turicella otitidis.