Integrated Approaches of Prevention and Medicine for Dealing with Central Nervous System Brucellosis:A Case from a Non-Epidemic Area—China,2023

What is already known about this topic?Brucellosis of the central nervous system(CNS)is rare and frequently fatal,often being overlooked or misdiagnosed.What is added by this report?In April 2023,the Jinan CDC identified a case of CNS brucellosis in a 54-year-old woman through cerebrospinal fluid(CSF)culture.Upon confirming the diagnosis of brucellosis,the Jinan CDC immediately informed Qilu Hospital of Shandong University,to which the patient had been transferred,and she was subsequently tracked and successfully treated.What are the implications for public health practice?The successful outcome can be attributed to the effective integration of a system that facilitated coordinated and collaborative actions between public health services and clinical institutions.

Utility of next-generation sequencing for the etiological diagnosis of Orientia tsutsugamushi infection

Background Scrub typhus,an acute febrile disease caused by Orientia tsutsugamushi,is transmitted to humans through infected chigger mites.We present a case of scrub typhus in a previously healthy man from Shandong Province diagnosed using next-generation sequencing(NGS)and PCR and review recent literature on NGS for scrub typhus diagnosis.Methods NGS was utilized for testing whole blood collected on admission.Confirmatory testing was done by detecting IgM and IgG antibodies to Orientia in acute and convalescent sera by ELISA.Orientia 47-kDa protein gene TaqMan and standard PCR of the 56-kDa protein gene and Sanger sequencing were performed on eschar scab DNA.Results The NGS diagnosis was confirmed by 47-kDa protein gene TaqMan and sequencing of a fragment of the O.tsutsugamushi 56-kDa protein gene from the eschar scab.Analysis of this sequence and the NGS data indicated O.tsutsugamushi strain Cheeloo2020 is a novel genotype.Mapping of the NGS data against the O.tsutsugamushi Gilliam strain genome sequence identified 304 reads with high similarity.Conclusions NGS is not only useful for multiplex diagnosis of scrub typhus,but also provides insight into the genetic diversity of O.tsutsugamushi.The common failure to submit sequences to databases makes it difficult to determine the minimal quantity and quality of NGS data being used for the positive identification of Orientia DNA in clinical specimens.

Diagnostic and prognostic value of disulfidptosis-related genes in sepsis

Background:Sepsis is a disease associated with high morbidity and mortality rates,especially among the elderly and patients in intensive care units.Disulfidptosis,a newly identified form of cell death triggered by disulfide stress,is emerging as a significant factor in disease progression.This study aimed to explore the diagnostic and prognostic value of disulfidptosis-related genes in sepsis.Methods:We obtained two datasets from the Gene Expression Omnibus(GEO)database to conduct our anal-ysis.Functional enrichment analysis was performed to identify relevant biological pathways.A protein-protein interaction network was constructed to identify hub genes critical to sepsis.Additionally,we analyzed the im-mune infiltration status in sepsis patients.The diagnostic value of these hub genes for sepsis was evaluated using nomograms,receiver operating characteristic(ROC)curves,and calibration curves in both training and valida-tion datasets.Finally,a miRNA-immune-related hub genes(miRNA-IHGs)regulatory network was developed to elucidate the synergistic interactions between miRNAs and their target genes.Results:A total of 3,469 differentially expressed genes(DEGs)were identified,of which seven were related to disulfidptosis(DR-DEGs).Functional enrichment analysis showed that DR-DEGs were significantly enriched in pathways related to actin dynamics.Five hub genes(MYH10,ACTN4,MYH9,FLNA,and IQGAP1)were identified as central to these processes.The analysis of immune infiltration revealed significantly lower levels of 11 immune cell types,while macrophages and regulatory T cells were significantly elevated in sepsis patients.The area under the ROC curves(AUCs)of the IHGs risk prediction model were 0.917 and 0.894 for the training and validation sets,respectively.A miRNA-IHGs regulatory network,comprising 17 nodes and 27 edges,was constructed,with MYH9 being the most frequently regulated by miRNAs.Conclusion:The pathophysiological process of sepsis appears to involve disulfidptosis,highlighting it as a potential new therapeutic targets for sepsis management.