BACKGROUND:The COVID-19 pandemic has affected the epidemiology of Mycoplasma pneumoniae pneumonia (MPP). This study aimed to provide a comprehensive overview of research trends, challenges, and advancements in pediatric MPP, particularly in the post-COVID-19 era. METHODS:A bibliometric analysis of pediatric MPP literature (1992-2025) from the Web of Science was conducted using VOSviewer and CiteSpace. RESULTS:A total of 2357 relevant articles were published by 11,318 authors from 2714 institutions across 94 countries. Publications increased significantly during and after the COVID-19 pandemic. China and the United States were the most influential countries, while Soochow University and Capital Medical University were the most active institutions. The top 10 co-cited references included four research articles and six review articles. Over the past 34 years, the research focus has shifted from community-acquired pneumonia (CAP) and pediatric pulmonary diseases to MPP. Current research hotspots include epidemiology, diagnostics, macrolide resistance, refractory MPP, and co-infections, with recent citation bursts related to COVID-19. CONCLUSION:This bibliometric analysis provides a systematic overview of pediatric MPP research from the 1990s to the post-COVID-19 era. It highlights the need for stronger global collaboration and further epidemiological studies to address MPP-related challenges, especially amid evolving infectious threats like COVID-19. IMPACT:This study offers a comprehensive overview of pediatric Mycoplasma pneumoniae pneumonia (MPP) research from 1992 to 2025, revealing critical changes and advances in the field. Detailed analyses of core contributors, thematic evolution, research hotspots and frontiers advance the overall understanding of pediatric MPP. The findings reveal persistent challenges in epidemiology, diagnostics, macrolide resistance, refractory MPP, and co-infections. This study highlights the necessity of strengthening global collaboration and conducting continuous epidemiological surveillance on MPP amid emerging infectious threats such as COVID-19. These results provide valuable insights for addressing clinical challenges and developing novel therapeutic strategies.

To assess the prevalence and genetic basis of pretomanid (Pa) resistance, further to generate additional MIC data to support ECOFF/breakpoint setting in the microdilution system. Mycobacterium tuberculosis (MTB) isolates were collected from national drug resistance surveillance regions, with no prior pretomanid exposure. All strains were sub-cultured on Löwenstein-Jensen medium and tested against 12 anti-tuberculosis drugs with the Sensititre® MYCOTB plate. Pretomanid was serially diluted in 7H9 broth supplemented with 10

To characterize the mutation profile of the ahpC gene in isoniazid resistance (INHr) Mycobacterium tuberculosis (MTB) isolates and to evaluate the correlation between specific mutations and resistance levels, a total of 1,337 INHr MTB isolates were collected through the Chinese Drug Resistance Surveillance Program (2013-2020). The minimum inhibitory concentrations (MICs) for INH, rifampicin (RIF), and ethionamide were determined by broth microdilution, followed by whole-genome sequencing analysis. Among 1,337 INHr-MTB isolates, 45.5% (608/1,337) were multidrug-resistant (MDR), and 54.5% (729/1,337) were RIF-sensitive cases, with lineage 2 predominating (1,013/1,337, 75.8%). Resistance mutations were identified in 79.1% (1,058/1,337) of strains, primarily katG Ser315Thr (65.5%, 695/1,058) and inhA C-777T (19.7%, 208/1,058). Notably, 5.3% (56/1,058) isolates harbored standalone ahpC mutations, with 83.3% (5/6) C-81T, 60.0% (9/15) G-48A, 57.1% (4/7) C-54T, 50.0% (3/6) C-57T, and 42.1% (8/19) C-52T mutations showing high-level INH resistance. Accordingly, 91.7% (11/12) dual katG315+inhA mutations conferred high-level INH resistance, while ahpC C-57T mutants universally exhibited MDR. The ahpC mutations are associated with high-level INH resistance in variants without concurrent katG or inhA mutations. This finding significantly advances our understanding of tuberculosis resistance profiling, enabling more comprehensive detection of INHr-MTB and optimizing therapeutic strategies.IMPORTANCEAmong INH-resistant MTB clinical isolates, mutations in the ahpC promoter region have been considered to occur in combination with other mutations, such as katG and inhA, in a compensatory role. While the ahpC mutations have been incorporated into the World Health Organization (WHO)-recommended rapid diagnostic test, Xpert MTB/extensively drug-resistant tuberculosis (XDR), it has been still ambiguous about the standalone effects on INH resistance spectrum. Our findings demonstrate that the ahpC mutations are associated with high-level INH resistance in variants without concurrent katG or inhA mutations. This finding significantly advances our understanding of TB resistance profiling, enabling a more comprehensive detection of INHr-MTB and optimizing therapeutic strategies.

OBJECTIVES:Non-sputum based, child-friendly triage tests are urgently needed to achieve accurate diagnosis and monitoring of tuberculosis (TB) in children. We aimed to assess an Xpert MTB Host Response (MTB-HR) assay, which provides a TB score based on the mRNA expression level of three host genes, for diagnosis and differentiation TB in children and adolescents. METHODS:The multicenter, prospective study was conducted in four provinces of China among children and adolescents who were admitted to hospitals for TB or latent tuberculosis infection (LTBI) screening. Subjects were included in the evaluation of Xpert-MTB-HR from February 2020 to December 2021. Baselines of TB scores were analyzed in healthy children and adolescents with various ages. Accuracy was evaluated in subjects with various TB status, including microbiological data, disease severity and age. RESULTS:Based on a composite clinical reference standard, among 780 patients enrolled, 403, 41, 109, and 227 were diagnosed as TB, LTBI, non-TB infectious diseases (DC) and healthy controls (HC), respectively. The mean TB scores decreased from 4 (IQR, 3·54-4·46) in infants to 0·91 (IQR, -0·23-2·04) in adolescents aged 17-18 years old. Using the composite clinical reference standard, the area under curves (AUCs) of the MTB-HR assay in discriminating ATB from HC, LTBI, and DC were 0·786 (95% CI, 0·749-0·823), 0·652 (95% CI, 0·559-0·744) and 0·771 (95% CI, 0·718-0·823), respectively.The optimal cutoff value was less than or equal to 2·675, resulting a sensitivity of 75·9% (95% CI, 67·0%-80·9%) and specificity of 70·5% (95%CI, 60·3%-76·7%) in TB diagnosis. The MTB-HR assay showed better auxiliary effect for diagnosis of ATB in children younger than five years of age (AUC, 0·885, 95% CI, 0·824-0·945, P=0·0006). The mean TB scores elevated at one month (P=0·0009) and three months (P=0·0061) after anti-TB treatment initiation. CONCLUSIONS:The MTB-HR assay showed potential for ATB diagnosis and treatment monitoring in children and adolescents, especially in ages under five years old.

The Haarlem genotype is a significant yet understudied part of the Euro-American lineage of Mycobacterium tuberculosis, characterized by unique pathogenetic features. Spoligotyping is a primary method for its detection, but it is not suitable for isolates with long blocks of deleted spacers. We have developed a simple and robust method to detect the Haarlem genotype. The real-time PCR (RT-PCR) assay with LNA probes was designed to detect the Rv0282 211 C > T mutation that was shown to be specific for the Haarlem genotype. The developed RT-PCR assay was optimized with 68 isolates with known whole-genome sequencing (WGS) data and applied to the geographically and genetically diverse collection of 428 isolates. As a result, 396 isolates were concordantly assigned to either Haarlem or non-Haarlem genotypes by both methods, whereas 32 isolates were discrepant cases. Twenty-two isolates of "unknown genotype" (Russia, Belarus, and Poland) were assigned to Haarlem by SNP-based assay. WGS of these isolates confirmed the results of the RT-PCR assay. To conclude, the developed RT-PCR method provides a reliable detection of the Haarlem genotype in retrospective collections and under prospective epidemiological surveillance. Its actual proportion in M. tuberculosis populations in certain world regions is higher than previously thought. Abridged spoligoprofiles with large deleted blocks of spacers require caution in interpretation.

Tuberculosis screening in pediatric lupus nephritis (LN) patients presents unique diagnostic challenges. This study aimed to analyze the frequency of indeterminate QuantiFERON-TB Gold Plus (QFT-Plus) results among children with LN and the potential influence factors. A retrospective cohort study was conducted among patients under 18 years old with a confirmed diagnosis of LN screened for tuberculosis infection from January 2023 and August 2024. Demographic and clinical data were extracted from their electronic medical record, with categorical variables presented as frequencies and continuous variables as medians. Using SPSS 18.0 (Chicago, IL), we first performed univariate logistic regression to identify factors associated with indeterminate IFN-γ results (P < 0.05), then entered significant variables into multivariate models to determine independent predictors, reporting results as ORs, with statistical significance set at P < 0.05. Of 111 patients with LN, 49 (44.14

Difficulties in microbiologically confirming childhood tuberculosis (TB) can result in delayed treatment and increased disease severity. In this study, we for the first time used whole genome next-generation sequencing (NGS) to detect cell-free DNA (cfDNA) from Mycobacterium tuberculosis (MTB) in plasma from children. We enrolled 94 children with active TB and 32 children with other respiratory infections. Combining NGS with probe capture enrichment (targeted cfNGS) showed higher coverage and detecting capability than did NGS alone. The targeted cfNGS showed slightly lower sensitivity (31.9

The human gut microbiota is an important modulator of host immune responses and has a crucial role in the development of tuberculosis (TB). Evidences suggest that metabolites may function as a bridge between gut microbiome and TB progression in children. However, the underlying interactive mechanisms are not well explored. The results may provide useful insight into the role played by the gut microbiome in pulmonary TB in children. To explore the gut bacterial features and its interaction with plasma lipid metabolisms in children with TB. We enrolled children aged younger than 14 years old from Beijing Children’s Hospital and West China Second Hospital between January 2020 and June 2021. We investigated the gut bacterial community using 16S rRNA sequencing of 98 children with active TB, 37 other infectious diseases, and 80 healthy children. The plasma lipids were further analyzed using ultra-high-performance liquid chromatography coupled with mass spectrometry. Children with TB showed decreased diversity and species richness indices compared to healthy children. Significant increases in the abundance of Firmicutes and Actinobacteriota combined with a decrease in the abundance of Bacteroidetes and Proteobacteria were also observed in TB children when compared with healthy controls. Among children with TB, gut bacterial composition differed in subgroups with pulmonary and extrapulmonary TB, or subgroups with different Mycobacterium tuberculosis (MTB) load. Children with TB had a higher risk of fever (OR = 3.02, P = 0.005) and poor appetite (OR = 2.96, P = 0.02) than the controls. Several bacterial genera were associated with severe illness and clinical indices, such as aspartate aminotransferase levels and fever. The plasma lipids showedc difference between TB patients and the children with other infectious diseases. Eight genera with the highest relative abundance strongly correlated with the plasma lipids. The gut microbiome is compromised in TB children, with a correlation with the plasma lipid metabolites and clinical presentations. Integrating analysis of microbiome and metabolism may help improve precise diagnosis, treatment, and mechanism study for TB in children.

Background:Mycoplasma pneumoniae (M. pneumoniae) is a leading cause of community-acquired pneumonia in children. Post-COVID-19, a significant resurgence of M. pneumoniae infections has been observed in China, but whole-genome analyses on the genetic mechanisms driving this resurgence remain limited. Methods:We performed whole-genome sequencing on 169 M. pneumoniae isolates from Beijing and Baoding, collected before and after COVID-19. All M. pneumoniae genomes from GenBank were included for analysis. Genotypes were identified using multilocus variable-number tandem-repeat analysis (MLVA), multilocus sequence typing (MLST), phylogenetic analysis. Genomic conservation and transmission patterns were assessed via SNP distance. Findings:We identified a post-COVID-19 resurgence of M. pneumoniae infections among children, with infection rates peaking at 60%-70% in late 2023, higher than during the pandemic (10%-20%) and pre-pandemic (∼30%). Genomic analysis revealed distinct genotypes, with T1-2 (4-5-7-2) dominating in Beijing, and both T1-2 and T2-2 (3-5-6-2) prevalent in Baoding. Minimal SNP distances and genomic conservation indicated rapid spread of M. pneumoniae. Genomic analysis uncovered key genetic factors driving the outbreak: near-100% macrolide resistance and increased prevalence of the 4-5-7-2 genotype (enriched in virulence and metabolism-related genes). Interpretation:This study provides a comprehensive genomic analysis of genetic factors driving the outbreak. With near-100% macrolide resistance in China, urgent changes in treatment policies are needed. The rising prevalence of 4-5-7-2 and its functional advantages warrant close monitoring. Our findings offer insights into the outbreak causes and guide future prevention and control strategies. Funding:National Key R&D Program of China; Training Plan for High level Public Health Technical Talents.

BACKGROUND:Mycoplasma pneumoniae (MP) is a major cause of pediatric respiratory tract infections (RTIs), with recent increases in incidence and macrolide resistance. The epidemiology of MP, macrolide-resistant MP (MRMP), co-infection patterns, and their relationship with disease severity in the post-COVID era remain poorly understood. We analyzed temporal trends in MP infection and MRMP prevalence and assessed their association with severe community-acquired pneumonia (SCAP). METHODS:Children aged < 18 years hospitalized with RTIs at Beijing Children's Hospital were retrospectively enrolled during 2018-2024. Respiratory samples were tested for MP and macrolide resistance mutations. Data on co-infecting bacterial and viral pathogens were collected in clinical practice and retrospectively included in this study. We analyzed temporal trends and risk factors for SCAP. RESULTS:Among 8,453 children, MP-positive patients accounted for 39.7%, declining to 17.0% in 2021 and rising sharply to 62.8% in 2024. The highest MP-positivity rates were seen in children aged 5-9 years, although a notable increase occurred in children aged < 5 years in 2024. MRMP was detected in 96.9% of MP-positive cases, with resistance rates > 95% from 2022. After 2021, co-infections were detected in 19.9% of cases tested for bacterial and viral pathogens, most commonly involving human rhinovirus-MP, Haemophilus influenzae-MP, and Streptococcus pneumoniae-MP. Risk factors for SCAP included female sex, age > 5 years, cold season onset, pure MP infection, and MP co-infection. MRMP was not an independent predictor of SCAP. CONCLUSIONS:The burden of MP infection has resurged post-COVID, with sustained high macrolide resistance and evolving co-infection patterns. Our findings underscore the importance of ongoing surveillance and tailored management strategies for pediatric MP infections.

An observational, single-center study was conducted among hospitalized children with community-acquired pneumonia in the Baoding area. The objective was to compare the respiratory pathogen profiles and epidemiological patterns during and after the lifting of non-pharmaceutical interventions (NPIs, including mask-wearing, social distancing, lockdowns, etc.). A total of 9,362 hospitalized children diagnosed with CAP in Baoding from January 2022 to December 2023 were included. Both viral and bacterial pathogens were detected by multiplex PCR. The NPIs were lifted in Baoding from 2 December 2022. A comparative analysis was conducted on demographic data, epidemiological data, pathogen detection rates, and co-infection patterns that were compared between the full year 2022 and 2023. The detection rate of at least one pathogen significantly increased from 74.2% (2,925/3,940) in 2022 to 86.5% (4,690/5,422) in 2023 (P < 0.001). Mycoplasma pneumoniae, Streptococcus pneumoniae, human rhinovirus, respiratory syncytial virus (RSV), and Haemophilus influenzae were the predominant pathogens. Notably, co-infection rates rose from 25.1% (988/3,940) in 2022 to 45.1% (2,445/5,422) in 2023 (P < 0.001), particularly viral-bacterial co-infections. The positive detection rates for many pathogens among severe pneumonia cases increased. Additionally, an age shift in infection patterns was observed, with older children showing a higher prevalence of RSV. Following the lifting of NPIs, an increase in the detection rates of pathogens was observed, as were fluctuations in the dynamics of viral and bacterial pathogens, underscoring the urgent need to adapt clinical management and public health policies to address emerging infection trends. IMPORTANCE Community-acquired pneumonia (CAP) remains the leading infectious cause of death in children worldwide. Understanding the pathogens responsible for CAP is essential for effective diagnosis and treatment. This study examines the changes in respiratory pathogens and epidemiological patterns in children with CAP in Baoding, China, before and after the lifting of non-pharmaceutical interventions (NPIs). Data from 9,362 children diagnosed with CAP from January 2022 to December 2023 were analyzed. The detection rate of at least one pathogen increased significantly from 74.2% in 2022 to 86.5% in 2023. Notably, co-infection rates rose from 25.1% to 45.1%, with viral-bacterial co-infections being more common. This research underscores the urgent need to adapt clinical management and public health policies to address the changing infection trends, highlighting their importance and innovation in understanding the impact of NPIs on pediatric respiratory infections.

We retrospectively analyzed the epidemiological characteristics, mixed infections, and complications of chlamydial infection in pediatric inpatients based on a national database. The discharge data of pediatric inpatients with chlamydial infection was obtained from the Futang Research Center of Pediatric Development database from January 2016 to December 2022. A total of 10,211 patients with chlamydial infection were obtained, with patients < 1 year old predominantly (44.17

BACKGROUND:Mycoplasma pneumoniae (M. pneumoniae) is considered to be one of the causative agents of community acquired pneumonia in children with general or severe course of disease. Severe M. pneumoniae pneumonia (SMPP) has emerged as a crucial global health concern due to high mortality rate in children under 5 years, potentially life-threatening complications, and growing challenges in pediatric treatment associated with rising macrolide resistance. Additionally, MPP can be complicated by other bacterial and/or viral pathogens, which may exacerbate disease severity. After the lifting of strict non-pharmaceutical interventions (NPIs) worldwide, the dramatic rise of incidence of MPP in Asia and Europe was observed. AIM:To perform the comprehensive study of community acquired MPP cases registered in 2023 in Baoding Hospital, China. METHODS:A total of 1160 children from 1 month to 15 years old with confirmed MPP diagnosis were enrolled in the study. The blood and respiratory samples were collected within the 24 hours after admission. The hematological parameters, biochemical markers, cytokine profiles were assessed. The respiratory samples were tested for the presence of M. pneumoniae and other 23 bacterial/viral pathogens by multiplex polymerase chain reaction (PCR). The macrolide resistance mutations (A2063G, A2064G in the 23S rRNA gene of M. pneumoniae) were determined by PCR. RESULTS:Number of MPP cases has dramatically increased starting August with peak in November. SMPP and general MPP (GMPP) were identified in 264 and 896 of 1160 hospitalized children. The binary logistic regression analysis identified six [C-reactive protein (CRP), lactate dehydrogenase, procalcitonin, erythrocyte sedimentation rate, fibrin and fibrinogen degradation products (FDPs), D-dimer] and four (neutrophils, CRP, FDPs, prothrombin time) predictors of SMPP in age groups 2-5 years and 6-15 years, respectively. Children with SMPP showed significantly higher levels of cytokine interleukin (IL)-17F (2-5 years), and cytokines interferon-gamma, tumor necrosis factor-alpha, IL-10 (6-13 years). Concomitant viral/bacterial pathogens were determined in 24.3% and 28.0% cases of SMPP and GMPP. Among them, Streptococcus pneumoniae (S. pneumoniae) and Haemophilus influenzae (H. influenzae) were predominant. 93.2% cases of MPP were associated with macrolide resistant M. pneumoniae. CONCLUSION:Specific MPP epidemiological pattern associated with lifting NPIs was revealed: Increase of hospitalized cases, prevalence of S. pneumoniae and H. influenzae among concomitant pathogens, 93.2% of macrolide resistant M. pneumonia.

The pharmacokinetic profile of linezolid still needs further definition, and insufficient or excessive exposure may lead to treatment failure or development of adverse events. Our study aimed to establish a population pharmacokinetic (PPK) model for linezolid in children with bacterial infections, develop an optimal dosage, and evaluate its efficacy and safety. A total of 157 plasma samples from 80 patients were utilized in PPK modeling. A one-compartment model with first-order elimination was most suitable for describing the PK characteristics of linezolid. Weight and creatinine clearance were the significant covariates for clearance. The outcomes of Monte Carlo revealed that in children under 12 years, the probability of target attainment (PTA) for standard dosage (10 mg/kg q8h) was over 90.0% when minimum inhibitory concentration (MIC) ≤2 µg/mL, with a mere 1.4% probability of surpassing the safety threshold. Meanwhile, in children aged 12 years and above, the PTA for standard dosage (600 mg q12h) was over 83.0%, and the probability of surpassing the safety threshold was 0.0%. To take the results one step further, a total of 67 patients (using standard dosage) were enrolled in the efficacy and safety analysis. Of the patients, 95.5% were cured or improved clinical treatment outcomes, and 22.4% of the patients developed possible adverse events (AEs), and no patient experienced early discontinuation of linezolid due to AEs. The standard dosage of linezolid is effective and safe in children with bacterial infections (MIC ≤2 µg/mL). For pathogens with MIC >2 µg/mL, it is advisable to switch antibiotics or increase dosage.CLINICAL TRIALSThis study is registered with Chinese Clinical Trial Registry as ChiCTR 2200061207.

BACKGROUND:The respiratory microbiota plays a crucial role in the development of tuberculosis (TB). While existing research has underscored imbalances in the respiratory microbiota of adult patients with TB, information regarding the lower respiratory tract (LRT) microbiota in pediatric patients with TB remains scarce. METHODS:We employed 16S rRNA gene sequencing technology to investigate the LRT microbial communities of 85 children of different ages with active TB of different severities, 33 children with infectious diseases other than TB, and 48 sex- and age-matched healthy children. RESULTS:A marked imbalance in the respiratory microbiota was observed in children with TB, highlighted by reduced alpha diversity and a distinct microbial community structure. Comparative analysis indicated that patients with severe TB exhibited lower Neisseria levels than those with non-severe TB (1.01% vs. 3.93%, respectively; p = .02). Streptococcus and Gemella levels were lower in bacteriologically confirmed TB cases compared with clinically diagnosed cases, and higher in healthy children younger than 10 years old than in the older group. Spearman correlation analysis demonstrated significant associations between the microbiota of the LRT and cytokine concentrations in the sputum of children with TB (e.g., an inverse correlation between Veillonella and interleukin-17A). CONCLUSIONS:TB induced significant dysbiosis in the LRT microbiota of children that was associated with disease severity and the immunological response in the respiratory tract. Our findings may offer a deeper understanding of the role of the respiratory microbiome in TB pathogenesis and progression.

Objective To evaluate the accuracy of QuantiFERON-TB Gold Plus (QFT-Plus) assay, and analyze the quantitative interferon gamma (IFN-γ) responses to tuberculosis (TB) antigens and mitogen in children and adolescents with active TB and latent tuberculosis infection (LTBI) in China. Methods A retrospective study was conducted among patients <25 years old with suspected active TB or screened for LTBI. All patients underwent QFT-Plus tests at Beijing Children’s Hospital and Shenyang Chest Hospital from August 2022 to March 2024. Demographic and clinical data were extracted from their electronic medical record. Results A total of 18482 patients were recruited, including 179 (1.0%) patients with active TB disease, 334 (1.8%) LTBI and 17969 (97.2%) non-TB disease. The 5.8% (176/18482) patients had indeterminate results. The overall sensitivity for active TB was 83.4%, and specificity was 98.0%. The percent agreement between TB1 and TB2 was 90.3%. The IFN-γ production in response to mitogen and TB antigens observed among children <1 year of age was lower than that among other age groups. There was significant positive correlation between age and IFN-γ responses to mitogen, but negative correlation between age and IFN-γ responses to TB1 and TB2 antigen. Besides, there was no significant difference in response to QFT-Plus TB antigens in active TB and LTBI cases. Conclusion QFT-Plus assay is accurate in children and adolescents with active TB. IFN-γ responses to mitogen and MTB antigens are significantly affected by age. The new antigen tube TB2 increases the assay sensitivity.

Although previous studies have reported the dysregulation of respiratory tract microbiota in infectious diseases, insufficient data exist regarding respiratory microbiota imbalances in the lower respiratory tracts (LRTs) of children with Mycoplasma pneumoniae pneumonia (MPP). Here, we analysed the microbial community using 16S rRNA gene sequencing. Finally, bronchoalveolar lavage fluid (BALF) samples from 158 children with MPP and 29 with bacterial or viral pneumonia (control group) were collected. The diversity of the microbial community was significantly different between the two groups. A significantly increased abundance of Tenericutes and Mycoplasma was detected in the MPP group, exceeding 67% and 65% of the total bacterial population, respectively. Using Mycoplasma abundance as the diagnostic method, the sensitivity and specificity of the model was 97.5% and 96.6%, respectively. Compared to the mild MPP group, lower alpha diversity and significantly increased Mycoplasma abundance were found in the severe MPP group (P < 0.01). The abundance of Mycoplasma was positively correlated with complications and clinical indices in children with severe MPP compared with children with mild MPP. Our study describes the features of the LRT microbiota of children with MPP and uncovered its association with disease severity. This finding may offer insights into the pathogenesis of MPP in children.

2022 年 3 月 21 日,世界卫生组织(Word Health Organization,WHO)发布了 WHO consolidated guide-lines on tuberculosis.Module 5:management of tuberculosis in children and adolescents(简称《2022 年版指南》),并通过发布的实施手册为指南建议的实施提供引导.《2022年版指南》基于最新循证医学证据对儿童和青少年结核病管理加以规范,并重点更新了儿童和青少年结核病启用Xpert Ultra作为初始诊断以及利福平耐药性检测工具,启用整合的治疗决策路径,非重症患儿启用疗程4个月的治疗方案,在6周岁以下耐多药/利福平耐药结核病(MDR/RR-TB)患儿中可启用含贝达喹啉的治疗方案,在3周岁以下MDR/RR-TB患儿中可启用含德拉马尼的治疗方案,结核性脑膜炎可启用疗程6个月的强化治疗备选方案,启用向基层下沉的非中心化的结核病关怀模式和家庭为核心的整合的结核病关怀模式等内容.笔者现对《2022年版指南》进行介绍,并对其更新要点加以解读,旨在基于循证依据为我国儿童和青少年结核病诊疗领域同道提供参考.

Guanylate-binding proteins (GBPs) are a subfamily of interferon-inducible proteins that undertake distinct roles in the the context of bacteria, virus, chlamydia and parasites infections. These proteins exert a notable influence on the progression and outcomes of infectious diseases. Within the realm of host cell-autonomous immunity against pathogens, GBPs have been identified as the regulators of pyroptosis through canonical and noncanonical inflammasome activation pathways. In this review, we summarize the structure and evolution of GBP family members, the canonical and noncanonical inflammasome activation pathways, the roles of GBPs in regulating inflammasome activation, and the mechanisms of GBPs affecting infections induced by different pathogens. We hope to provide new basic research clues for the pathogenesis and diagnosis and treatment of infectious diseases.