Frontiers in Microbiology

Antimicrobial resistance (AMR) in ESKAPE pathogens represents a major global health threat. Although these organisms are well established as causes of healthcare-associated infections, aquatic environments may function as reservoirs and transmission pathways for resistance. This systematic review aimed to estimate the prevalence of AMR in ESKAPE pathogens isolated from water and wastewater and to compare resistance patterns with those observed in human clinical isolates. The review followed PRIS...

Abnormal respiratory microbiomes are reported in children with artificial airways, yet the timing and persistence of these disruptions have not been defined in infants following new tracheostomy placement. We conducted a prospective longitudinal study to characterize airway microbiome dynamics following new tracheostomy placement during early life, a critical period for microbiome development. Fifteen hospitalized infants <=12 months contributed 84 tracheal aspirate samples collected from day 1 ...

Antimicrobial resistance (AMR) is a growing global public health threat projected to cause up to 10 million deaths annually by 2050 if no immediate action is taken. While misuse and overuse of antibiotics are the main drivers of increasing AMR, the eco-evolutionary dynamics of AMR in the environment - particularly across the urban-rural continuum - remain poorly understood. Using shotgun sequencing, we investigated urban, farm, and rural water sources in the Berlin-Brandenburg region to explore ...

ObjectiveSevere tuberculosis (TB) is a major cause of critical illness and death in people living with HIV (PLWH) worldwide. Despite this, the immunopathology of severe HIV-associated TB (HIV/TB) is poorly understood. We aimed to identify an immunopathologic signature of severe HIV/TB in sub-Saharan Africa. Design and SettingWe analyzed proteomic data from two prospective observational cohorts of adults hospitalized with severe undifferentiated infection in Uganda: an urban discovery cohort (En...

Antibiotic resistance genes (ARGs) circulating among clinically relevant bacteria pose serious challenges to public health. Given the ancient and environmental bacterial origins of ARGs, a better understanding of the carriers of ARGs beyond the clinically most relevant species is urgently needed for more farsighted resistance monitoring and intervention measures. While the risks of emerging ARGs from environmental sources have been recognized, the identification bottlenecks stem from the limitat...

In nonsuppressible HIV viremia (NSV), individuals have persistently detectable viral load despite adherence to [&ge;]2 fully active antiretroviral drugs. NSV represents an area of clinical uncertainty and an opportunity to understand the mechanisms of HIV persistence. We performed in-depth virologic characterization to identify distinct NSV phenotypes. We categorized participants into those who had persistent viremia after antiretroviral therapy (ART) initiation (primary NSV) and those who had N...

Carbapenem-resistant (CR) bacteria have emerged and been spreading beyond healthcare-associated facilities into the environment. It is recognized that toilet bowl water in patient rooms of healthcare-associated facilities can be one of internal reservoirs of CR bacteria. In accordance with this idea, toilet bowl water samples were collected from patient rooms in a tertiary healthcare-associated facility in North Macedonia, and meropenem (MEM)-resistant bacterial isolates were obtained from the t...

We summarize an outbreak of N. gonorrhoeae ST16676 associated with disseminated gonococcal infections (DGIs) in Minnesota, USA in 2025. This novel strain replaced ST11184 as the predominant sequence type circulating among DGI cases in the state, encoded a porB1a allele, and carried a tetracycline resistance gene on a mobilizable plasmid.

The global increase in microbial infections is strongly linked to the widespread dissemination of antibiotic resistance genes in the environment, posing a serious challenge to public health. In the present study, surface water samples were collected from multiple locations along the Daya River near Bhubaneswar, including sites impacted by untreated municipal sewage discharge. The predominant bacterial isolate was identified as Acinetobacter baumannii-exhibited resistance to commonly used antibio...

IntroductionRates of sexually transmitted infections are on the rise globally, including those caused by Neisseria gonorrhoeae. Retrospective analyses across clinical settings around the world have indicated that rates of gonorrhea declined following mass vaccination campaigns vaccines made with outer membrane vesicles (OMV) from Neisseria meningitidis serogroup B, a pathogen closely related to N. gonorrhoeae. The US FDA-approved N. meningitidis serogroup B vaccine (4CMenB) contains N. meningiti...

BackgroundPeople with HIV (PWH) experience an increased burden of cardiovascular disease (CVD), partly driven by chronic immune activation despite antiretroviral therapy (ART). Tuberculosis (TB), a frequent co-infection, may leave persistent inflammatory sequelae even after cure, potentially accelerating hypertension and cardiovascular risk. Evidence on long-term cardiometabolic consequences of prior TB in virally suppressed PWH, particularly sex-specific effects, remains limited. MethodsIn a p...

BackgroundTuberculosis (TB) is a leading cause of morbidity and mortality among children living with HIV (CLHIV). Poor diagnostic performance is a significant contributor. Serological assays that determine levels of Mycobacterium tuberculosis reactive antibodies inconsistently detect TB. However, antigen-specific antibody Fc receptor engagement and effector functions are promising biomarkers of TB disease. MethodsThis study evaluated serum from a well-characterized cohort of Kenyan CLHIV via tw...

Candida auris is a multidrug-resistant fungal pathogen that presents substantial challenges for healthcare facilities due to its high mortality rates among vulnerable populations. Six C. auris clades have been identified based on their susceptibility to antifungal treatment and environmental stressors. Identifying the circulating C. auris clade(s) is critical for understanding transmission and selecting a disease control strategy. To inform targeted implementation of community wastewater monitor...

Strengthening in-country sequencing capacity generated 28 Lassa virus genomes from human clinical cases, expanding our knowledge of Lassa fever in Guinea. Phylogeographic analysis revealed cross-border exchange between Liberia and the NZerekore region, and a Sierra Leone introduction into the Gueckedou area. Enhanced genomic surveillance is crucial to guide future public health actions.

After the COVID-19 pandemic, wastewater monitoring is increasingly used for infectious disease surveillance. Using the data from a controlled experimental hospital setting, this paper examines the association wastewater SARS-CoV-2 with COVID-19 hospital admission and mortality, and whether this association varies by patients characteristics. Weekly wastewater samples were collected from the University of Miami (UM) hospitals where COVID-19 patients were admitted from February 2020 to October 202...

We genotyped 1189 multidrug-resistant Mycobacterium tuberculosis isolates identified during 2013-2022 in Argentina, through a mixed strategy using PCR-based methods and whole-genome sequencing. Epidemiological, geographic distribution and microbiological data were integrated. Most cases belonged to a cluster (75.7%). The proportion of orphan and clustered cases varied across regions. The Euro-American lineage4 was virtually predominant. The most important clusters, M, Ra, Rb and Callao2 strains,...

BackgroundThe never-ending emergence of superbugs casts a shadow over the victorious age of antibiotics. In fact, the triumph of antibiotics was previously viewed in retrospection as our final victory over bacteria. Bacteria like Klebsiella pneumoniae, Acinetobacter baumannii, and Escherichia coli are now raising an alarming number of infections across hospitals and communities around the globe. The objective was to evaluate the implications for antimicrobial stewardship based on identifying the...

Household transmission of EV-D68 was identified in 35 of 1040 households (3.4%) in the Pacific Northwest between 2022-2024, with an estimated secondary attack rate of 15%. Sequences from within households clustered closely with 0 to 2 pairwise nucleotide differences (median 1) between cases 6-14 days apart (median 7).

Klebsiella pneumoniae is a major causative agent of hospital-acquired infections worldwide, contributing substantially to morbidity, mortality, and healthcare burden.. The emergence of strains that combine resistance to last-resort antimicrobials with hypervirulence has become a pressing public-health challenge. Despite extensive characterization of the genetic determinants of multidrug resistance and hypervirulence, the relationship between the genetic repertoire of K. pneumoniae and the clinic...

Severe Acute Respiratory Infection (SARI) remains a major global health burden, yet conventional diagnostics frequently fail to identify the causative pathogens. This study aimed to comprehensively characterize the respiratory microbial landscape in adult SARI and to evaluate the clinical utility of an optimized long-read metagenomic next-generation sequencing (mNGS) workflow. A total of 101 respiratory specimens from hospitalized adults in northern Thailand (November 2023 to April 2024) were an...