Overlapping infections of Mycobacterium canariasense and Nocardia farcinica in an immunocompetent patient:A case report

BACKGROUND Infections by non-tuberculous mycobacteria(NTM)have become more common in recent years.Mycobacterium canariasense(M.canariasense)was first reported as an opportunistic pathogen in 2004,but there have been very few case reports since then.Nocardia is a genus of aerobic and Gram-positive bacilli,and these species are also opportunistic pathogens and in the Mycobacteriales order.Conventional methods for diagnosis of NTM are inefficient.Metagenomic next-generation sequencing(mNGS)can rapidly detect many pathogenic microorganisms,even rare species.Most NTM and Nocardia infections occur in immunocompromised patients with atypical clinical symptoms.There are no previous reports of infection by M.canariasense and Nocardia farcinica(N.farcinica),especially in immunocompetent patients.This case report describes an immunocompetent 52-year-old woman who had overlapping infections of M.canariasense,N.farcinica,and Candida parapsilosis(C.parapsilosis)based on mNGS.CASE SUMMARY A 52-year-old woman presented with a productive cough and chest pain for 2 wk,and recurrent episodes of moderate-grade fever for 1 wk.She received antibiotics for 1 wk at a local hospital,and experienced defervescence,but the productive cough and chest pain persisted.We collected samples of a lung lesion and alveolar lavage fluid for mNGS.The lung tissue was positive for M.canariasense,N.farcinica,and C.parapsilosis,and the alveolar lavage fluid was positive for M.canariasense.The diagnosis was pneumonia,and application of appropriate antibiotic therapy cured the patient.CONCLUSION Etiological diagnosis is critical for patients with infectious diseases.mNGS can identify rare and novel pathogens,and does not require a priori knowledge.

Axial load-share ratio testing to assess the healing of open tibial fractures treated with the Taylor Spatial Frame

Background:The Taylor Spatial Frame(TSF)has gained popularity among orthopedic surgeons for treating open fractures.However,a key challenge is the timely and safe removal of the frame.This study assessed the efficacy and safety of axial load-share ratio(ALSR)testing to evaluate callus healing strength after TSF treatment of open tibial fractures.Methods:A retrospective case-control study was conducted,analyzing 180 adult patients with open tibial fractures treated at Tianjin Hospital’s Orthopedic Limb Correction Unit between August 2019 and August 2022.All patients underwent TSF external fixation surgery,and were divided into two groups based on ALSR testing.Group I(92 patients)underwent ALSR testing,with frame removal if the test value fell below 5%.Traditional methods were used for fixator removal guidance in Group II(88 patients).Clinical outcomes,including fixation duration,complications after fixator removal,and Johner-Wruhs functional scores,were compared between the two groups.Results:The groups showed no statistically significant differences(P>0.05)in sex,age,injury side,body mass index,surgery timing,or fracture type.Group I had a significantly shorter fixation duration(25.85±5.57 weeks)compared to Group II(31.82±6.98 weeks)(P<0.05).Following fixator removal,Group I demonstrated superior Johner-Wruhs scores compared to Group II,indicating better outcomes(P<0.05).Complication rates did not differ significantly between the groups at the last follow-up(P>0.05).Conclusion:Regular postoperative ALSR testing could safely and effectively guide TSF removal following open tibial fracture treatment.This method significantly reduced fixation duration compared to traditional guidance methods while maintaining efficacy and safety.

Microbial community composition and environmental response characteristics of typical brackish groundwater in the North China Plain

To reveal the microbial community composition of regional shallow porous brackish groundwater and its response characteristics to groundwater environment,the first and second aquifers in Taocheng District,Hengshui City were selected,and 10 groundwater source samples were collected for hydrochemical analysis and microbial 16S RNA gene V4-V5 regional sequencing.The results showed that the shallow brackish groundwater in the study area is weakly alkaline and has high ion content.The hydrochemical types are SO_(4)·Cl-Na·Mg type and HCO3·Cl-Na·Mg type as a whole.The spatial zonation of the abundance and diversity of groundwater microorganisms is obvious.The number of endemic bacteria in groundwater from upstream,midstream to downstream is 11,135 and 22 respectively,with a total of 22 bacteria.Proteobacteria is the most dominant in groundwater level(38.82%-86.88%),and there are obvious differences in different sections.At the genus level,the main dominant species in each group and sample are Pseudomonas and Hydrogenophaga.In terms of composition difference,Pseudohongiella,Pseudorhodobacter and Limnohabitans are the representatives of UR,MR and LR.On the whole,the composition of flora in groundwater in the study area is sensitive and closely related to hydrochemical processes.Species abundance is affected by alkaline and high salinity environmental indicators,while species diversity is related to depth and dissolved oxygen in weak reduction environment.

Risk assessment,fitness cost,cross-resistance,and mechanism of tetraniliprole resistance in the rice stem borer,Chilo suppressalis

The rice stem borer(RSB),Chilo suppressalis,a notorious rice pest in China,has evolved a high resistance level to commonly used insecticides.Tetraniliprole,a new anthranilic diamide insecticide,effectively controls multiple pests,including RSB.However,the potential resistance risk of RSB to tetraniliprole is still unknown.In this study,the tetraniliprole-selection(Tet-R)strain was obtained through 10 continuous generations of selection with tetraniliprole 30%lethal concentration(LC_(30)).The realized heritability(h^(2))of the Tet-R strain was 0.387,indicating that resistance of RSB to tetraniliprole developed rapidly under the continuous selection of tetraniliprole.The Tet-R strain had a high fitness cost(relative fitness=0.53).We established the susceptibility baseline of RSB to tetraniliprole(lethal concentration at LC_(50)=0.727 mg/L)and investigated the resistance level of 6 field populations to tetraniliprole.All tested strains that had resistance to chlorantraniliprole exhibited moderate-to high-level resistance to tetraniliprole(resistance ratio=27.7-806.8).Detection of ryanodine receptor(RyR)mutations showed that the Y4667C,Y4667D,I4758M,and Y4891F mutations were present in tested RSB field populations.RyR mutations were responsible for the cross-resistance between tetraniliprole and chlorantraniliprole.Further,the clustered regularly interspaced palindromic repeats(CRISPR)/CRISPR-associated protein 9-mediated genome-modified flies were used to study the contribution of RyR mutations to tetraniliprole resistance.The order of contribution of a single RyR mutation to tetraniliprole resistance was Y4667D>G4915E>Y4667C~~I4758M>Y4891F.In addition,the I4758M and Y4667C double mutations conferred higher tetraniliprole resistance than single Y4667C mutations.These results can guide resistance management practices for diamides in RSB and other arthropods.