Access Microbiology

In 2024, Chicago experienced a measles virus outbreak. Air samples collected as part of routine respiratory virus surveillance from three hospitals that received measles patients were retrospectively analyzed. Measles virus was detected in air samples from one emergency department across five weeks when measles patients were present and another when no known cases were present. Two of three viral sequences derived from air samples were identical to measles patients. The source of one diverging sequence could not be identified and may represent a case not identified by traditional surveillance methods. Air sampling may supplement measles investigation, surveillance and response.

BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is one the most common cause of post-surgical infections in Malawi and poses a significant public health challenge due to resistance to commonly used antibiotics. We isolated and evaluated the stability and lytic activity of a MRSA-specific bacteriophage (Staphylophage) from Mzuzu Central hospital (MZCH) sewage against MRSA strains isolated from surgical wards. MethodsA prospective in vitro experimental study was conducted using 56 pus swabs collected from post-surgical patients at Mzuzu Central Hospital (MZCH), Malawi. Standard microbiological methods and VITEK analysis were used for bacterial isolation, identification and antimicrobial susceptibility testing of Staphylococcus aureus and MRSA according to the 2024 EUCAST guidelines. A lytic Staphylophage was isolated and purified from sewage wastewater using filtration, enrichment, and double-layer agar techniques. The purified Staphylophage was evaluated for its lytic activity through host range testing and stability under ultraviolet (UV) exposure (up to 60 minutes), different pH levels (2-12), and temperatures (4{degrees}C, -20{degrees}C, and -80{degrees}C). ResultsOut of 56 bacterial isolates, 18 (32.1%) were S. aureus, of which 11 (61.1%) were MRSA. The isolated Staphylophage showed lytic activity against 87% of Staphylococcus species tested. The phage remained stable at temperatures between -80{degrees}C and 4{degrees}C and across a pH range of 2- 12. It also retained viability after UV exposure for up to 15 minutes, although a reduction in phage titre was observed after 30 minutes. ConclusionsA lytic Staphylophage isolated from hospital sewage at MZCH demonstrated activity against Staphylococcus species, including MRSA strains from post-surgical wound infections. These findings illustrate the feasibility of generating candidate phages for alternative therapeutic approaches in a central hospital setting in Malawi.

Morganella morganii is an opportunistic pathogen with intrinsic and acquired antimicrobial resistance, but its genomic epidemiology remains poorly characterized in Bangladesh. We sequenced and compared genomes of 47 stool-derived M. morganii isolates from hospital (n = 29) and community (n = 18) participants in urban Dhaka. Susceptibility testing showed frequent resistance to imipenem (70.2%) and cefuroxime (97.9%), while all isolates were resistant to colistin. Resistance to meropenem (6.4%) and ertapenem (2.1%) was uncommon. Based on acquired non-susceptibility across tested antimicrobial categories, 18/47 (38.3%) isolates were multidrug-resistant, including 15/29 (51.7%) hospital-derived and 3/18 (16.7%) community-derived isolates. Genomic analysis identified 17 {beta}-lactamase alleles including Morganella-associated chromosomal {beta}-lactamases and acquired resistance determinants, with blaOXA-1, blaDHA-21, blaCTX-M-15, and blaTEM-1 predominating. However, no recognized acquired carbapenemase genes were detected. Among 44 non-{beta}-lactam resistance genes, tetB was most frequent. Phylogenomic and average nucleotide identity analyses classified 31 isolates as M. morganii subsp. morganii and 16 as the subsp. intermedius lineage. Considerable population diversity was observed, with 33 distinct sequence types among the 47 isolates and no clear clustering by hospital or community origin. The subsp. intermedius isolates showed greater genomic heterogeneity than subsp. morganii, with a minimum within-group average nucleotide identity of 94.2%. Single nucleotide variant (SNV) analysis identified several closely related isolate groups, including an ST1 pair differing by 10 SNVs and collected three days apart within the same hospital, although direct transmission could not be established. Virulence-associated gene profiles differed between subspecies, with hemolysin- and toxin-associated genes predominantly detected among subsp. morganii isolates and largely absent from subsp. intermedius. Overall, these findings reveal substantial genomic diversity, a considerable burden of multidrug resistance, and subspecies-associated differences in virulence gene content among M. morganii circulating in Dhaka, while the frequent imipenem-non-susceptible but carbapenemase-negative phenotype highlights the need to investigate alternative carbapenem resistance mechanisms.

Background: Klebsiella pneumoniae is a key causative agent of multidrug resistant nosocomial infections. Bacteriophages offer a promising alternative treatment, but the diversity of Klebsiella species requires the characterisation of a broad range of phages, particularly the poorly characterised jumbo phages. Materials and Methods: Phage BMCPR_005026 was isolated from sewage against Klebsiella pneumoniae. Whole genome sequencing, transmission electron microscopy and host range analysis against a diverse set of 40 clinically relevant Klebsiella strains were used to characterise the phage. Results: The virion had a myovirus morphology and genomic analysis placed it within an undefined family in Caudoviricetes where it forms a new species within the genus Alcyoneusvirus. BMCPR_005026 could form plaques on 3 of the 40 Klebsiella strains tested (7.5%) and formed halos. Conclusion: BMCPR_005026 represents a new species of phage within the genus Alcyoneusvirus with activity against 3 Klebsiella KL-types.

Human noroviruses (HuNoVs) are the most common cause of non-bacterial foodborne illnesses worldwide. HuNoVs are notoriously difficult to culture, and current cell culture systems, such as human intestinal enteroids have limitations in efficiency and scalability, which has limited their applications in food safety studies. Recently, it has been shown that transformed salivary gland cell lines (including NS-SV-TT-DC) allow for replication and passaging of norovirus GII.4. Herein, we examined whether we can independently observe viral replication in salivary gland cells and if other strains of human norovirus can replicate in these cells. For this purpose, we first evaluated the replication of several norovirus strains in NS-SV-TT-DC cells by either infecting them with vesicle-cloaked viruses or total viruses in stool filtrates. Low levels of viral replication was observed and vesicle isolation did not improve viral replication. Next, we screened for replication of 50 norovirus samples from 9 genotypes, and 14 isolates demonstrated over a two-fold viral replication. We observed that the initial viral load in the samples does not have a significant effect on replication efficiency. We were also able to passage several isolates. Subsequently, we examined whether interferon inhibitors such as Ruxolitinib, TPCA-1, and BX795 would improve viral replication and observed negligible effects. Finally we tested multiple supplements including MgCl2, bile salt, ceramide, and TAK-779. Most supplements had little or no effect on HuNoV replication in NS-SV-TT-DC cells. Bile salt and TAK-779 showed limited, genotype-specific benefits. Altogether these results indicate that salivary gland cells allow limited replication of certain HuNoV isolates.

Macrolides remain the first-line antimicrobial treatment for pertussis, primarily caused by Bordetella pertussis. Emergence of macrolide-resistant B. pertussis in Australia and globally presents a growing concern for clinical management. As molecular diagnosis predominates for pertussis, limited numbers of cultures are available for antimicrobial susceptibility testing. The A2037G mutation in the 23S rRNA gene is most commonly associated with macrolide resistance in B. pertussis, yet no commercial molecular assay is available for its detection. In this study, we adapted and validated a previously published real-time PCR assay as a laboratory developed test (LDT) on the Panther Fusion(R) system using Open Access functionality to detect the macrolide resistance-associated mutation in B. pertussis from culture isolates and clinical specimens. Total turnaround time was ~2.5 h for the first result and 2-3 min for subsequent results in the same batch, with an estimated cost of AUD 18 per sample, excluding labour. A total of 30 samples were included in the validation panel to assess assay performance. All isolates and clinical specimens in the validation panel produced results concordant with the expected mutation status, demonstrating 100% accuracy, sensitivity and specificity. The assay demonstrated a limit of detection of 1.5 x 103 CFU/mL (22 CFU/reaction). This Panther Fusion(R) LDT provides a rapid and fully automated approach for molecular detection of the targeted mutation associated with macrolide resistance in B. pertussis. Its integration into routine molecular workflows as a reflex test following identification of B. pertussis may facilitate timely identification of resistant infections.

Introduction: In temperate regions, influenza and respiratory syncytial virus (RSV) typically exhibit seasonal epidemics during the winter months, often concurrently with SARS-CoV-2 epidemics. Monitoring past and real-time trends in infection dynamics is important for informing public health situational awareness, including identifying and characterising unusual epidemic activity. However, data used to monitor these trends can exhibit substantial noise including strong day-of-the-week variation in reporting. In addition, case data for influenza can obscure distinct trends in influenza subtypes if not combined with virological data. Aim: By quantifying trends in respiratory virus activity using statistical methods, the Australia-Aotearoa Consortium for Epidemic Forecasting and Analytics (ACEFA) aims to provide government partners with comprehensive epidemic intelligence. Methods: Analyses were performed on daily case time series data for SARS-CoV-2, RSV and influenza across Australia's eight jurisdictions. Past and real-time trends were inferred for each pathogen and each influenza subtype using Bayesian p-spline models. Results: The 2025 Winter Situational Assessment Program provided weekly reports throughout the winter season and during the out-of-season influenza A H3N2 epidemic, driven by the emergence of the novel influenza subclade ('subclade K'). Despite limited subtyping data, our analysis provided an early signal of increasing influenza A H3N2 during a period in which overall influenza cases were decreasing; increases in influenza A H3N2 activity were first detected in July, and by mid-August, increasing H3N2 activity was estimated across all jurisdictions. Discussion: Our analysis highlights the benefits of incorporating statistical methods into real-time epidemic situational assessment and in consolidating reporting across jurisdictions.

Bordetella pertussis is the main aetiological agent of pertussis (whooping cough), with a global resurgence of cases reported in 2024. As current pertussis diagnostics are predominantly based on molecular methods, cultured isolates are increasingly scarce, limiting traditional culture-based surveillance. To address these challenges, this study evaluated culture-independent approaches for B. pertussis surveillance and their feasibility for implementation in public health laboratory settings in Victoria, Australia. The Microbiological Diagnostic Unit Public Health Laboratory received 356 nasopharyngeal clinical specimens that were PCR-positive for Bordetella spp. from diagnostic laboratories for further characterisation during the 2024-2025 epidemic period. Culture-based approaches yielded only five B. pertussis isolates, largely due to limitations associated with specimen transport media. Four culture-independent approaches were evaluated for B. pertussis characterisation: real-time PCR assay for high-resolution Bordetella spp. differentiation (n=356), multiplex PCR amplicon sequencing assay for lineage typing (n=38), in-house laboratory developed test implemented on Panther Fusion(R) System for macrolide resistance screening (n=92) and shotgun metagenomic sequencing (n=5). The dataset was dominated by B. pertussis (330/356; 92.7%) with most strains harbouring ptxP3 (35/38; 92.1%) allele and the macrolide resistance rate was reported as 4.3% (4/92). Shotgun metagenomics was able to detect B. pertussis directly from clinical samples, but the genomic recovery was limited. Evaluation of operational performance and workflow integration highlighted method-specific strengths and limitations, informing suitability for implementation in public health laboratories. This study demonstrates the potential to integrate culture-independent approaches into public health laboratory settings to strengthen B. pertussis surveillance and inform feasible workflow design amid limited culture availability.

Co-administration of phages and antibiotics has been proposed as a therapeutic approach against antibiotic-resistant bacteria. The relationship, however, between antibiotic resistance and phage resistance in clinical isolates is unclear. Here, we examine associations between phage and antibiotic resistance profiles across a panel of Pseudomonas aeruginosa clinical isolates from the Centers for Disease Control (CDC) and Food and Drug Administration (FDA) Antimicrobial Resistance Isolate (ARI) Bank comprising 55 clinical strains with full genome sequences and antibiotic susceptibility testing (AST) data for 11 clinically relevant antibiotics. As phages in this study, we use three well-characterized, morphologically distinct phages, OMKO1, Luz19, and PAML31-1. We screen for phage resistance using a growth suppression assay, then conduct statistical analysis against antibiotic MIC (Minimum Inhibitory Concentration) data provided by the CDC to define association patterns across this dataset. We find multiple significant susceptibility correlations between pairs of antibiotics and phages, and a positive overall association between average phage resistance and antibiotic resistance across the 55 strains, even controlling for phylogenetic associations (=0.358, p<0.005). We conclude that phage and antibiotic resistance are positively associated across this clinical isolate collection, suggesting that the two resistance phenotypes are not independent in P. aeruginosa. These findings have implications for the development of phage-antibiotic cocktails.

The Gardnerella genus includes a complex sub-taxonomy of bacterial species and subgroups which have been implicated in bacterial vaginosis. We analyzed G. leopoldii, G. swidsinski, G. piotii, and G. vaginalis genomes available in public databases and predicted proviral sequences using Cenote-Taker3. We clustered 266 prophage sequences into 140 viral genera level groupings that encode four distinct gene clusters and 19 different lysin proteins. Analysis of the bacterial and prophage sequence phylogenies reveals that while there were no specific prophage sequence lineages that infected each bacterial host, there is clustering of the prophage sequences by bacterial species within the Gardnerella genus.

Methanogens, a diverse group of archaea that produce methane during energy metabolism, are prevalent in anoxic habitats where they are exposed to viral infections. The head-tailed virus {Psi}M2 is one of few virus isolates that infect a methanogen host and was described as a lytic virus that lyses its host, Methanothermobacter marburgensis. Here, we present evidence that {Psi}M2 does not exclusively follow the classic lytic lifecycle but can also enter an alternative, chronic infection-like state. Growth experiments showed that infected cultures in minimal medium, optimized for the methanogen host (MS medium) did not exhibit complete lysis but continuously released infective virions. In contrast, in a suboptimal complex medium (SAB medium), the {Psi}M2-infected culture released virions in the exponential growth phase and eventually lysed after 14 hours post infection. Although the genome of {Psi}M2 encodes a putative integrase, a prerequisite for lysogeny, whole genome sequencing of {Psi}M2-infected M. marburgensis cultures revealed that the viral DNA remained extrachromosomal rather than integrating into the host genome, likely due to a mutation in the integrase gene. These findings suggest that {Psi}M2 enters a non-lytic lifecycle alternative to lysogeny under suboptimal host growth conditions. Sequencing further identified a heterogeneous viral population including previously undescribed variants. A high density of non-synonymous mutations and frameshift-inducing insertions was observed within ORFs predicted to encode a capsid protein and a major spike protein, suggesting these viral variants to differ in host recognition and infectivity. Overall, our results show more complex viral behavior and greater genetic variability than previously described.

Urbanisation is widely recognised as a major driver of environmental change, yet its impacts on soil microbiomes remain poorly understood, particularly outside megacities and beyond bacterial taxa. Population density is frequently used as a proxy for urban intensity, but its relevance across different microbial kingdoms and urban contexts is unclear. Here, we investigated how soil microbial communities vary across population density bands in the regional, temperate city of Hobart, Australia. Using a multi-kingdom metabarcoding approach, we analysed bacterial, fungal, and protozoan communities from soils collected in urban green spaces along a population density gradient. Bacterial alpha-diversity differed significantly across population density bands, exhibiting an inverse U-shaped relationship, with the highest diversity at green spaces in intermediate population density areas. In contrast, fungal and protozoan alpha-diversity did not vary with population density. Community composition (beta-diversity) did not differ consistently across density bands for any microbial group, and variation in soil physicochemical properties explained more community variation than population density alone. These results indicate that population density is a selective, rather than universal, driver of urban soil microbiomes and that responses to urbanisation differ markedly among microbial kingdoms. Our findings highlight important limitations of using population density as a sole indicator of urban impact and challenge the generalisability of conclusions drawn from bacteria-focused studies in large cities. By demonstrating kingdom-specific and context-dependent responses in a regional city, this study underscores the need for multi-kingdom, multi-scale approaches to better understand how urbanisation shapes soil microbiomes and their potential implications for urban ecosystem functioning and human health.

Sepsis is a substantial contributor to neonatal mortality in Africa, with Klebsiella pneumoniae as the leading causative pathogen. Incorporating molecular tools such as whole genome sequencing (WGS) into routine surveillance of important bacterial pathogens, including those causing neonatal sepsis, can support targeted deployment of infection prevention and control measures and treatment interventions. This study aimed to understand the current practices and capacity for culture, identification and genomic analysis of bacterial pathogens in Africa, with a particular focus on K. pneumoniae, to support standardised genomic surveillance. A cross-sectional online survey was distributed to various clinician and scientist networks across Africa. All respondents completed a demographics section, while sections on laboratory test capacity, blood culture practices, WGS, and bioinformatics analysis were completed based on experience in these aspects. Responses were received from 52 institutions in 25 African countries. Among 51 institutions completing the laboratory test capacity section, 61% reported performing blood cultures, with the majority using manual commercial biochemical systems for species identification (71%) and manual disk diffusion for antibiotic susceptibility testing (82%). Participating institutions reported near-universal access to a -80{degrees}C freezer, centrifuge and thermocycler, but shaking incubators were less commonly available (67%). More than half of respondents (54%) indicated that they perform the entire WGS workflow (including DNA extraction, library preparation and WGS) internally, with most performing DNA extraction internally (88%) using column-based kits (70%). Outsourcing was progressively more common at later workflow stages. Infrastructure challenges that limit bioinformatics analysis capabilities were reported by all 23 respondents who completed this question, including limited access to high-performance computing and data storage space. This survey found sufficient capacity to support genomic surveillance of neonatal sepsis pathogens across participating African institutions. However, investments in blood culture, supply chains, sequencing, bioinformatics, and data dissemination capacity are needed to realise its full potential. These findings will support the development of standardised genomic surveillance protocols tailored to the diverse capacities of African laboratories.

Carbohydrate inducible promoters on expression plasmids are widely used for biotechnology and basic science research. However, using carbohydrates for inducers has drawbacks including influencing bacterial metabolism, the inducer being used as a carbon source by the bacteria, high background expression, and only a subset of cells experiencing promoter activation. Furthermore, some bacteria including the pathogen Acinetobacter baumannii currently lack good carbohydrate-inducible promoters. To address this issue, a tetracycline-inducible promoter, PtetB, isolated from A. baumannii was cloned and evaluated in a number of important bacteria: Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Pseudomonas fluorescens, and Serratia marcescens. A highly sensitive luxCDABE reporter was used to evaluate promoter activity. S. marcescens strains with elevated and reduced cyclic-AMP levels were used to evaluate the impact of cAMP on PtetB function. The PtetB promoter was induced over 800-fold in A. baumannii and 10-750-fold inducible in the other tested species. Background expression was lower from PtetB in the pseudomonads than previously described carbohydrate inducible promoters. Data indicated that the PtetB promoter system may be a useful tool for future basic science research with the tested bacteria.

Background: More than five years after the COVID-19 outbreak, the infection by the SARS-CoV-2 virus should still be considered as a global threat with highly heterogeneous clinical outcomes from asymptomatic to fatal depending on existing genetic and phenotypic inter-individual and inter-population variability. Our objective is to identify risk loci associated with COVID-19 in an admixed Latin American population. Methods: We performed a genome-wide association study in the framework of the Chilean C19-GenoNet team, analyzing a cohort of 3,417 individuals recruited from the northernmost to the southernmost regions of the country, who presented variations in the severity of their COVID-19 clinical manifestations. Results: Our investigation replicated the extensively reported association of several variants at the 3p21.31 locus with COVID-19 severity and found a suggestive association for a variant within the FOXP4 gene at 6p21.1 with COVID-19 hospitalization. Both associations appear to be shared with other populations. Importantly, our study identified three previously unreported loci associated with COVID-19 severity or hospitalization at 7q21.11, 16p13.12 and 6p25.3, and one additional locus at 4p13 associated with SARS-CoV-2 positivity, a proxy for infection susceptibility. Conclusions: these new risk loci may represent population-specific effects in Chilean and, potentially, other Latin American admixed groups. Our study highlights the importance of expanding efforts to study underrepresented and genetically different populations, which may provide new clues on the genetic basis of human diseases and may help to anticipate global responses to emerging viral infections and future pandemics.

Human rhinovirus (HRV), a major cause of upper respiratory infections, has increasingly been associated with lower respiratory tract disease. Although tools to investigate HRV pathogenesis are needed, they remain limited. Reporter viruses expressing fluorescent or luminescent proteins are powerful tools for analyzing viral distribution and replication; however, insertion of a reporter gene often impairs viral replication, and the inserted gene is readily lost during serial passage. To address these problems, we established a versatile and stable strategy for generating reporter HRV and other enteroviruses. The gene encoding mScarlet3, a red fluorescent protein, was inserted between the 5'UTR and VP4 gene, a site previously used in other enteroviruses but not in HRV. Optimizing the 2A cleavage sequence between mScarlet3 and VP4 yielded a reporter HRV with growth kinetics comparable to those of the wild-type virus. To improve the genetic stability of the reporter insert, we evaluated GC-content optimization of the reporter gene and relocation of the cis-acting replication element (CRE). GC-content optimization substantially improved reporter stability in both HRV-B14 and EV-A71, whereas CRE relocation provided additional stabilization in EV-A71 but not in HRV-B14, demonstrating the potential applicability of this strategy to other enteroviruses. This strategy for constructing stable reporter HRV and other enteroviruses will facilitate studies of enterovirus pathogenesis.

Prevotella melaninogenica is a Gram-negative bacterium that has been implicated in numerous disorders such as chronic obstructive pulmonary disease (COPD) and cystic fibrosis, and despite its abundance in the human microbiome, there is still limited knowledge on the fundamental physiology describing Prevotella melaninogenica. To properly advance Prevotella biology, it is critical to report and document such characterizations of Prevotella; therefore, the purpose of this study is to examine and define the phenotypic and growth characteristics of P. melaninogenica ATCC 25845. In this study, we found that Prevotella melaninogenica ATCC 25845 is a Gram-negative bacterium that is predominantly short and medium rod-shaped, with occasional filamentous rods. SEM imaging revealed that this filamentation may serve as division centers, points from which multiple daughter cells form. We also describe the antibiotic profile, which showed susceptibility to four classes and resistance to six classes of antibiotics. Carbon source growth kinetic characterization revealed a preference for carbohydrate sources.

Background: Hepatitis E virus (HEV) is highly endemic in several African countries with high mortality rate among pregnant women. The prevalence of HEV in Niger among pregnant women is unknown. We hereby aim to report the prevalence and risk factors of HEV among pregnant women in Niamey, Niger. Methods: Blood samples were collected from pregnant women attending antenatal consultation in three selected Health centers in Niamey. Data were collected for socio demographic characteristics using a structured questionnaire. Samples were tested using ELISA and qRT-PCR for anti- HEV IgM and RNA detection respectively. HEV associated risk factors were determined using multivariate logistic regression models. Results: A total of 491 pregnant women were enrolled with mean age of 26.5 years. The prevalence of anti-HEV IgM antibodies was 17.1%, while HEV RNA was detected in 3.46% of participants, indicating recent and active HEV infection. Anti-HEV IgM seropositivity was more frequent among women aged 26-30 years and those in the third trimester of pregnancy. Gravidity was significantly associated with HEV RNA positivity (p = 0.032). In multivariable analysis, the use of well water was independently associated with HEV infection (aOR = 75.70; 95% CI: 1.23-4643.20; p = 0.039). Conclusion: In view of the high seroprevalence of HEV among pregnant women, preventive measures including hygiene sensitization should be prioritized. Further studies should be conducted to assess the real impact of HEV infection on maternal and fetal health.

Skin ulcers, such as those observed in cases of the non-venereal disease yaws and the venereal disease syphilis, are traditionally diagnosed based on their anatomical location and visible appearance. Yet various evidence suggests that the pathogens that cause these ulcers may not be restricted to genital or non-genital body sites. We explored this by profiling the bacterial communities of genital and non-genital skin ulcers collected in Ghana using 16S rRNA gene amplicon sequencing. Swab samples were collected from 156 clinically diagnosed skin lesions (110 non-genital and 46 genital). The V1-V2 region of the 16S rRNA gene was sequenced to characterize bacterial communities. Microbial diversity, community composition, differential abundance, and associations between lesion diversity and common skin bacteria were analysed using bioinformatics and statistical methods. Following quality filtering, 135 samples were retained, revealing 23 bacterial phyla, 143 families, and 406 genera. Alpha diversity indicated similar bacterial richness and diversity in genital and non-genital skin lesions. Beta diversity analyses indicated differences between genital and non-genital lesions, accompanied by significant differences in within group dispersion. A log2 fold change analysis evidenced genital lesions were enriched in Gardnerella, whereas non-genital lesions showed more abundance of Staphylococcus, Streptococcus, Corynebacterium, Bradyrhizobium, and Pelomonas. Clinically important genera, including Treponema, Haemophilus, and Mycobacterium, were also detected, even in samples with low sequencing depths. Statistical modelling indicated that greater microbial diversity was associated with intermediate abundances of common skin taxa, particularly Corynebacteriaceae, Micrococcaceae, Cutibacterium, and Staphylococcaceae, thereby attesting the presence of polymicrobial communities in skin ulcers. Overall, genital and non-genital skin lesions showed similar microbial diversity but differed in composition. Our findings support the view of skin lesions as ecological niches containing diverse bacterial communities rather than being consistently dominated by a single bacterial taxon. They provide a basis for investigating possible polymicrobial interactions in skin ulcers.

BackgroundHuman Mastadenovirus B (HAdV-B) causes ocular and respiratory infections and is capable of causing outbreaks in healthcare settings. HAdV-B114, a recombinant genotype only formally recognised in 2023, has been reported predominantly from Germany, the USA, China and Japan; genomic data from UK clinical settings remain limited. This study analysed 68 HAdV-B whole genomes from ocular and respiratory-associated samples collected at a Nottingham hospital across the pre- and post-COVID-19 restriction periods (2017-2023). MethodsClinical samples typed positive for HAdV-B by partial hexon Sanger sequencing were selected for whole-genome sequencing using a novel overlapping PCR amplicon strategy, sequenced on the Oxford Nanopore Technologies PromethION platform. Phylogenetic and pairwise difference analyses were used to characterise genotype composition and genomic relatedness. SimPlot and amino-acid comparison characterised divergence between sub-lineages. ResultsWhole-genome phylogenetics confirmed that two species B genotypes were detected in Nottingham University Hospitals between 2017-23: HAdV-B114 (n=56) and HAdV-B7 (n=12). HAdV-B114 was detected before and after COVID-19 restrictions, with an increase in 2022-2023, consistent with post-restriction expansion of a pre-existing lineage. Pairwise difference analysis identified 24 genomically identical B114 sequences; associated metadata argued against a single nosocomial transmission chain interpretation, with the pattern more consistent with repeated detection of a widely circulating community strain, with the possibility of localised onward transmission. Within the B114 clade, multiple monophyletic groups were identified by whole-genome phylogenetics. ConclusionsThis study adds whole-genome resolution to the existing UK HAdV-B114 data, demonstrates the utility of WGS for clinical adenovirus surveillance and shows the benefits of combining epidemiological data with genomic analysis.