Advances in the Diagnosis of Infectious Diseases and Microorganisms: 2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 3417

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Guest Editor
IRD, AP-HM, MEPHI, Aix Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
Interests: mimivirus; metagenomics; virophages; megavirales; mobilome; emerging viruses; hiv; viral hepatitis
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Special Issue Information

Dear Colleagues,

There have recently been interesting advances in virological and microbiological diagnostic laboratories. These have notably consisted of the extended use of diagnostics through a syndromic approach, particularly using multiplex PCR, and also the introduction and increasing use of diagnosis through next-generation sequencing. These technologies can help improve the completeness and informativeness of infection diagnoses. They help, for example, to detect numerous viral, microbial or mixed co-infections, the epidemiological and clinical significance of which deserves careful analysis. Here, we describe examples of the implementation and optimization of virological diagnoses involving these approaches. Such diagnostic strategies can be combined with real-time monitoring of the numbers of clinical specimens sampled to search for infectious etiologies and of the numbers of positive diagnoses of infectious agents, in order to detect abnormal events which may correspond to emerging phenomena and epidemics.

Prof. Dr. Philippe Colson
Guest Editor

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Keywords

  • clinical microbiology
  • antimicrobial resistance
  • diagnostic microbiology
  • molecular microbiology
  • HIV
  • infectious diseases

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Published Papers (4 papers)

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Research

16 pages, 1942 KB  
Article
Fecal Metabolomics for the Diagnosis of Clostridioides difficile Infection
by Carlos Bea-Serrano, Andreu Belmonte-Domingo, Carolina Pinto-Pla, Ana Ferrer-Ribera, Sara Vela-Bernal, Ana Isabel de Gracia-León, Andrea de Castro-Oliver, Lucas Serna-Navarro, Celia Prades-Sirvent, David Ruiz-Raga, María José Galindo, María José Forner-Giner and María Rosa Oltra-Sempere
Diagnostics 2025, 15(18), 2331; https://doi.org/10.3390/diagnostics15182331 - 15 Sep 2025
Viewed by 295
Abstract
Background: Clostridioides difficile infection (CDI) is the leading cause of nosocomial diarrhea. Current diagnostic tools have difficulty distinguishing between colonization and active infection. This study evaluated the utility of fecal metabolomics in diagnosing CDI in hospitalized patients with acute diarrhea. Methods: [...] Read more.
Background: Clostridioides difficile infection (CDI) is the leading cause of nosocomial diarrhea. Current diagnostic tools have difficulty distinguishing between colonization and active infection. This study evaluated the utility of fecal metabolomics in diagnosing CDI in hospitalized patients with acute diarrhea. Methods: We conducted a prospective observational study involving hospitalized adults with new-onset diarrhea during admission. Participants were stratified into groups based on clinical and microbiological findings: controls, C. difficile colonized and C. difficile infected. Fecal samples were analyzed using UPLC-MS/MS and GC-MS to quantify selected short-chain fatty acids, amino acids, and bile acids. Multivariate and univariate statistical analyses included PLS-DA, sPLSDA, and tests with FDR correction. Results: Infected patients exhibited significantly higher concentrations of SCFAs and notable alterations in bile acid profiles. Key discriminative metabolites included isovalerate, propionate, isobutyrate and alpha-aminobutyric acid. ROC curve analyses showed strong diagnostic performance for these markers, with AUC values exceeding 0.85. Conclusions: Fecal metabolomic profiling could effectively differentiate between colonization and infection in CDI among hospitalized patients with diarrhea. These results highlight the potential of metabolomic signatures to enhance the diagnostic precision for CDI. Full article
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18 pages, 760 KB  
Article
Antineutrophil Cytoplasmic Autoantibodies Specific to Bactericidal/Permeability-Increasing Protein: A Cross-Road Between Prolonged Gram-Negative Bacterial Infections and Ulcerative Colitis/Primary Sclerosing Cholangitis
by Dragana Jovanovic, Rada Miskovic, Aleksandra Plavsic, Sara Radovic, Ljudmila Nagorni-Obradovic, Dragan Popovic, Milos M. Nikolic and Branka Bonaci-Nikolic
Diagnostics 2025, 15(18), 2309; https://doi.org/10.3390/diagnostics15182309 - 11 Sep 2025
Viewed by 355
Abstract
Background/Objectives: Binding of bactericidal/permeability-increasing (BPI) protein to Gram-negative (GN) bacteria plays a major role in bacterial elimination. The relationship between BPI-antineutrophil cytoplasmic autoantibodies (ANCA), persistent infections and immunoinflammatory diseases has not been elucidated. Methods: In total, 193 ANCA-positive patients detected by [...] Read more.
Background/Objectives: Binding of bactericidal/permeability-increasing (BPI) protein to Gram-negative (GN) bacteria plays a major role in bacterial elimination. The relationship between BPI-antineutrophil cytoplasmic autoantibodies (ANCA), persistent infections and immunoinflammatory diseases has not been elucidated. Methods: In total, 193 ANCA-positive patients detected by IIF with ANCA-associated vasculitides (AAV, n-40), connective tissue diseases (CTD, n-28), drug-induced vasculitides (DIV, n-17), ulcerative colitis (UC, n-24), UC with primary sclerosing cholangitis (UC/PSC, n-14), Crohn’s disease (CD, n-10), autoimmune hepatitis (AIH, n-19) and chronic infections (n-41) were tested using the BPI-ANCA quantitative and semiquantitative ELISA (ANCA-profile: BPI, proteinase 3, myeloperoxidase, elastase, cathepsin G, lactoferrin). BPI-ANCA were analyzed in 52 healthy persons. Results: A total of 46/193 (23.8%) patients had BPI-ANCA positivity. BPI-ANCA were more frequently present in patients with prolonged GN bacterial infections and inflammatory bowel diseases than in AAV, DIV, AIH, CTD and healthy controls (p < 0.001). UC/PSC patients more frequently had BPI-ANCA than UC and CD patients (p < 0.001). GN bacterial infections more frequently had BPI-ANCA than Gram-positive bacterial infections (p < 0.001). Infections caused by Pseudomonas aeruginosa and Mycobacterium tuberculosis had monospecific BPI-ANCA (sensitivity 79% and 71%, respectively). UC/PSC and chronic GN bacterial infections caused by Klebsiella pneumoniae, Proteus mirabilis, or Escherichia coli had multispecific BPI-ANCA (sensitivity 64% and 100%, respectively). Odds ratio analysis showed that patients with IBD who were positive for multispecific BPI-ANCA had a 13.5-fold increased risk of UC/PSC (95% CI 2.98–61.18). Conclusions: Monospecific BPI-ANCA may be a valuable biomarker for persistent Pseudomonas aeruginosa and Mycobacterium tuberculosis infections. In contrast, multispecific BPI-ANCA are associated with UC/PSC and persistent infections caused by intestinal Gram-negative bacteria. Suppression of antimicrobial function by multispecific BPI-ANCA could impair the elimination of Gram-negative bacteria, sustaining the immunoinflammation. Dysregulated antimicrobial response might be the target of immunomodulatory therapy in the initial phase of BPI-ANCA-positive UC/PSC. Full article
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20 pages, 3217 KB  
Article
Microbiome of the Proximal Small Intestine in Patients with Acute Pancreatitis
by Vladimir V. Kiselev, Stanislav I. Koshechkin, Alexey V. Kurenkov, Vera E. Odintsova, Maria S. Zhigalova, Alekxandr V. Tyakht, Sergey S. Petrikov, Petr A. Yartsev and Ilya V. Dmitriev
Diagnostics 2025, 15(15), 1911; https://doi.org/10.3390/diagnostics15151911 - 30 Jul 2025
Viewed by 692
Abstract
Currently, due to the complexity of obtaining samples, specific features of laboratory processing and analysis of the results, there is a lack of data on the microbial signature of the small intestine in healthy and diseased states of the upper gastrointestinal tract. Objective: [...] Read more.
Currently, due to the complexity of obtaining samples, specific features of laboratory processing and analysis of the results, there is a lack of data on the microbial signature of the small intestine in healthy and diseased states of the upper gastrointestinal tract. Objective: To investigate the characteristics of the small intestinal microbiome in acute pancreatitis of varying severity and to identify correlations with clinical factors. Methods: This study included 30 patients with acute pancreatitis of varying severity treated between 1 January 2019 and 31 December 2021. The composition of the microbiota was analyzed by metagenomic sequencing of the 16S rRNA gene from jejunal samples. Results: The mortality rate in the study group was 23.3%. The small intestinal microbiome was dominated by Streptococcus (median relative abundance 19.2%, interquartile range 6.4–35.1%), Veillonella (3.4%; 0.6–7%), Granulicatella (2.7%; 0.6–5%), Fusobacterium (2.2%; 0.3–5.9%), Prevotella (1.5%; 0.3–8%), Haemophilus (0.9%; 0.2–10%), Gemella (0.8%; 0.2–4.3%), and Lactobacillus (0.2%; 0.1–0.9%). More severe disease was associated with decreased abundance of Neisseria mucosa, Parvimonas micra, and Megasphaera micronuciformis. In contrast, the relative abundance of the genera Streptococcus (species S. rubneri/parasanguinis/australis), Actinomyces, and several genera within the family Enterobacteriaceae was higher in these patients. Conclusions: The state of the microbiota has important prognostic value and correlates with the duration from the onset of the pain syndrome to the time of receiving qualified care in the hospital. Full article
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11 pages, 455 KB  
Article
Do the Results of Bile Cultures Affect the Outcomes of Patients with Mild-to-Moderate Ascending Cholangitis? A Single Center Prospective Study
by Yoav Krupik, Eran Ariam, Daniel L. Cohen, Anton Bermont, Sergei Vosko, Haim Shirin and Shay Matalon
Diagnostics 2025, 15(6), 695; https://doi.org/10.3390/diagnostics15060695 - 11 Mar 2025
Cited by 1 | Viewed by 1611
Abstract
Background/Objectives: Bile cultures are recommended in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). We sought to evaluate if bile cultures affect the outcomes of patients with mild-to-moderate ascending cholangitis. Methods: Bile cultures were prospectively obtained from patients undergoing ERCP between 2021 and 2023 at [...] Read more.
Background/Objectives: Bile cultures are recommended in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). We sought to evaluate if bile cultures affect the outcomes of patients with mild-to-moderate ascending cholangitis. Methods: Bile cultures were prospectively obtained from patients undergoing ERCP between 2021 and 2023 at a single gastroenterology unit. The primary outcome was the prognosis of patients with mild-to-moderate ascending cholangitis who received appropriate antibiotic coverage with empiric antibiotics versus those with bacteria resistant to the empiric antibiotics. Additionally, outcomes between those with positive and negative biliary cultures were assessed. Results: One hundred sixty ERCPs were conducted, including 65 (40%) for ascending cholangitis with a naive papilla. Of these, 43 (66.2%) had a positive bile culture. Fourteen (32.6%) described mixed bacteria. Enterococcus spp. was the most common bacteria (22, 51.2%), followed by E. coli (17, 39.6%). Patients that were treated with appropriate antibiotics had similar outcomes compared to those who received inappropriate antibiotics per bile culture susceptibilities in terms of length of hospitalization (7.8 days vs. 7.9 days), in-hospital mortality, 30-day readmissions, and 30-day mortality (p ≥ 0.21, ns). There were also no differences in those outcomes between patients with positive and negative bile cultures (p ≥ 0.09, ns). Conclusions: These results question the need for obtaining bile cultures in every ERCP performed, including those with cholangitis. They imply that decompression of the biliary tree during ERCP is the more significant aspect of treatment, rather than the selection of an appropriate antibiotic regimen. Additional studies are needed to assess the benefits of acquiring bile cultures in all cases of ascending cholangitis. Full article
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