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Flynn TG, Olortegui MP, Kosek MN. Viral gastroenteritis. Lancet 2024; 403:862-876. [PMID: 38340741 DOI: 10.1016/s0140-6736(23)02037-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 08/17/2023] [Accepted: 09/18/2023] [Indexed: 02/12/2024]
Abstract
Since the discovery of norovirus in 1972 as a cause of what was contemporarily known as acute infectious non-bacterial gastroenteritis, scientific understanding of the viral gastroenteritides has continued to evolve. It is now recognised that a small number of viruses are the predominant cause of acute gastroenteritis worldwide, in both high-income and low-income settings. Although treatment is still largely restricted to the replacement of fluid and electrolytes, improved diagnostics have allowed attribution of illness, enabling both targeted treatment of individual patients and prioritisation of interventions for populations worldwide. Questions remain regarding specific genetic and immunological factors underlying host susceptibility, and the optimal clinical management of patients who are susceptible to severe or prolonged manifestations of disease. Meanwhile, the worldwide implementation of rotavirus vaccines has led to substantial reductions in morbidity and mortality, and spurred interest in vaccine development to diminish the impact of the most prevalent viruses that are implicated in this syndrome.
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Affiliation(s)
- Thomas G Flynn
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | | | - Margaret N Kosek
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.
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Bengtsson RJ, Baker KS, Cunningham AA, Greig DR, John SK, Macgregor SK, Seilern-Moy K, Spiro S, Chong CC, De Silva PM, Jenkins C, Lawson B. The genomic epidemiology of Escherichia albertii infecting humans and birds in Great Britain. Nat Commun 2023; 14:1707. [PMID: 36973246 PMCID: PMC10043262 DOI: 10.1038/s41467-023-37312-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Escherichia albertii is a recently identified gastrointestinal bacterial pathogen of humans and animals which is typically misidentified as pathotypes of diarrhoeagenic Escherichia coli or Shigella species and is generally only detected during genomic surveillance of other Enterobacteriaceae. The incidence of E. albertii is likely underestimated, and its epidemiology and clinical relevance are poorly characterised. Here, we whole genome sequenced E. albertii isolates from humans (n = 83) and birds (n = 79) isolated in Great Britain between 2000 and 2021 and analysed these alongside a broader public dataset (n = 475) to address these gaps. We found human and avian isolates typically (90%; 148/164) belonged to host-associated monophyletic groups with distinct virulence and antimicrobial resistance profiles. Overlaid patient epidemiological data suggested that human infection was likely related to travel and possibly foodborne transmission. The Shiga toxin encoding stx2f gene was associated with clinical disease (OR = 10.27, 95% CI = 2.98-35.45 p = 0.0002) in finches. Our results suggest that improved future surveillance will further elucidate disease ecology and public and animal health risks associated with E. albertii.
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Affiliation(s)
- Rebecca J Bengtsson
- Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, The University of Liverpool, Liverpool, UK
| | - Kate S Baker
- Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, The University of Liverpool, Liverpool, UK.
| | - Andrew A Cunningham
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
| | - David R Greig
- Gastrointestinal and Food Safety (One Health) Division, UK Health Security Agency, Colindale, London, UK
| | - Shinto K John
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
| | - Shaheed K Macgregor
- Wildlife Health Services, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
| | - Katharina Seilern-Moy
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
| | - Simon Spiro
- Wildlife Health Services, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
| | - Charlotte C Chong
- Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, The University of Liverpool, Liverpool, UK
| | - P Malaka De Silva
- Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, The University of Liverpool, Liverpool, UK
| | - Claire Jenkins
- Gastrointestinal and Food Safety (One Health) Division, UK Health Security Agency, Colindale, London, UK
| | - Becki Lawson
- Institute of Zoology, Zoological Society of London, Regent's Park, London, NW1 4RY, UK
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Use of Metagenomic Next-Generation Sequencing in the Clinical Microbiology Laboratory: A Step Forward, but Not an End-All. J Mol Diagn 2021; 23:1415-1421. [PMID: 34756275 DOI: 10.1016/j.jmoldx.2021.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 12/13/2022] Open
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