Pathogens
Top medRxiv preprints most likely to be published in this journal, ranked by match strength.
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The host response to Neisseria gonorrhoeae is variable, and understanding its systemic and local components is critical to understanding anti-gonococcal immunity for vaccine development. We used a controlled human infection model of male gonococcal urethritis in naive volunteers in combination with multiplex cytokine analyte analysis of blood and urine specimens taken before infection, at the time of acute symptoms, and after curative treatment of N. gonorrhoeae to study responses to early infec...
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Antimicrobial resistance (AMR) is a growing problem, with annual deaths set to pass 10 million by 2050 if current trends continue. Wastewater surveillance has been proposed as a strategy to understand population-level resistance, and water reclamation facilities (WRFs) have been identified as a control point for environmental dissemination of resistant bacteria. Understanding dynamics of AMR across WRFs requires advanced molecular tools that elucidate host bacteria, especially for mobile resista...
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IntroductionSequence-based typing (SBT) has been the standard molecular typing method for understanding Legionella pneumophila genetic relationships. However, genome-scale typing approaches, namely core-genome (cg) or whole-genome (wg) multilocus sequence typing (MLST), provide higher discriminatory power. To advance these capabilities, the Legionella International Typing (LIT) workgroup was established to develop, evaluate, and disseminate a novel cgMLST schema with enhanced wgMLST resolution f...
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The two largest US measles outbreaks in over two decades (2025 Gaines County, Texas: 414 cases, contained; 2025-2026 Spartanburg County, South Carolina: 923+ cases, ongoing) occurred in counties with similar sub-threshold K-12 MMR coverage (85.1% vs 88.8%), yet their trajectories diverged dramatically. Using kernel density estimation with a common bandwidth and bootstrap uncertainty quantification, we compared sub-county vaccination data at the district level for Texas (3 districts, 3,560 studen...
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BackgroundNontyphoidal Salmonella enterica (NTS) is a major public-health threat in the United States of America (U.S.). Evaluating associations between serovars, exposure sources, and settings in multistate outbreaks can reveal the drivers of NTS transmission and guide prioritization of targeted prevention and control strategies. MethodsWe analyzed multistate animal-contact NTS outbreaks reported to the CDC National Outbreak Reporting System during 2009-2022. We calculated incidence rates per ...
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BackgroundAfrica continues to have a significant public health problem with mpox, where endemic transmission persists and overlaps with a high burden of other infectious diseases. Although their epidemiology and clinical impact are still poorly understood throughout the continent, coinfections with human immunodeficiency virus (HIV) and varicella-zoster virus (VZV) can affect the clinical picture, severity of the disease, and accuracy of the diagnosis. MethodsFollowing PRISMA criteria, we regis...
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Microbial keratitis is a sight-threatening corneal infection with varying etiological agents, primarily bacteria and fungi. Assessing and contrasting the virulence factors of microorganisms isolated from a non-contact lens-associated keratitis (NCLAK) and contact lens-associated keratitis (CLAK) is the goal of the current investigation. Samples were collected from over 60 patients and analysed using standard microbiological techniques, including culture, Gram staining, KOH mount, biochemical tes...
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The resurgence of measles in the United States, driven by declining childhood vaccination coverage, poses a substantial public health and economic threat. Using county-level MMR vaccine coverage data and spatial incidence models, we quantified the economic burden of measles in 2025 and projected the impact of continued declines in vaccine uptake. In 2025, the estimated cost per measles case was $104,629 (50% High-Density Interval [HDI]: $100,729-$110,140), yielding a national burden of $244.2 mi...
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BackgroundPreoperative biliary stenting alters biliary colonization and may reduce the effectiveness of perioperative antibiotic prophylaxis in pancreatoduodenectomy. Although broader-spectrum regimens have been associated with improved infectious outcomes, their microbiological adequacy in routine clinical practice remains poorly defined. We therefore evaluated the real-world adequacy of a prolonged ampicillin-sulbactam protocol, its association with infectious outcomes and survival, and the po...
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BackgroundViral hemorrhagic fevers (VHFs) remain a major public health threat in resource-limited settings. The 2014-2016 Ebola virus disease epidemic exposed critical gaps in laboratory preparedness and diagnostic capacity in most-at-risk countries, including Guinea. Sustainable in-country laboratory capacity is essential for early detection and rapid response to VHF outbreaks, including Lassa fever. MethodsA long-term laboratory capacity-strengthening programme was implemented in Guinea, comb...
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IntroductionHemophagocytic lymphohistiocytosis (HLH) is a serious condition induced by Dengue virus which becomes fatal if not detected early and treated appropriately. So objectives of the present study are to observe the different patterns of presentations, clinical features and outcome of HLH induced by Dengue. MethodsIn this observational study, 14 patients admitted and diagnosed HLH as per diagnostic criteria, were included after informed written consent. Study conducted in a period of six...
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ObjectivePreterm birth (PTB) is a leading cause of neonatal morbidity and mortality worldwide, with India alone contributing nearly 27% of the global PTB burden. Although alterations in the vaginal microbiome have been implicated in PTB, its association in the Indian context is underexplored. This study aimed to investigate the association of vaginal microbiome and PTB in Indian women at the time of delivery. Study designThe vaginal swabs were collected at the time of delivery from 72 women (31...
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IntroductionDengue has been prevalent in a regular fashion in Bangladesh and Chattogram for the last 6-7 years and is showing some serotype twisting. So, the objectives of the present study were to explore the burden of dengue serotypes in Chattogram. MethodsIn this study, 223 Dengue RT-PCR positive patients were evaluated for serotyping. Gender and age group, along with cycle threshold (CT) values, were also collected. Data after collection were compiled, analyzed, and plotted in Microsoft Exc...
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BackgroundSevere Fever with Thrombocytopenia Syndrome (SFTS) is an acute infectious disease with high mortality. This study aimed to develop a quantitative scoring system for grading SFTS severity using dynamic clinical data. MethodsA retrospective study included 547 confirmed SFTS patients from two hospitals. Clinical data were collected over a 14-day course (divided into four phases). Patients were grouped into survivors (n=451) and non-survivors (n=96). Statistical analyses, including Kaplan...
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Hepatitis E virus (HEV) is considered a predominantly foodborne pathogen in developed settings. During COVID-19 lockdown periods, however, HEV concentrations in wastewater at a treatment plant in Munich, Germany decreased, suggesting that pandemic-related behaviour changes inadvertently influenced transmission. In contrast, reported cases and wastewater data from a smaller catchment showed no comparable decline. To assess whether the observed reduction is compatible with a near-exclusively foodb...
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In the past decade, dengue fever has emerged as a major public health on Reunion Island in the Southwest Indian Ocean. During the 2018-2022 outbreak, an unusual increase in ocular complications was reported in some patients. To investigate a potential viral cause, we analysed 447 blood samples from hospitalized patients with and without ophthalmic symptoms. Genetic sequencing revealed the co-circulation of two strains of dengue virus serotype 1, both genetically linked to strains previously iden...
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Infectious disease forecasts can inform public health decision-making. Wastewater monitoring is a relatively new epidemiological data source with multiple potential applications, including forecasting. Incorporating wastewater data into epidemiological forecasting models is challenging, and relatively few studies have assessed whether this improves forecast performance. We present and evaluate a semi-mechanistic wastewater-informed forecasting model. The model forecasts COVID-19 hospital admissi...
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BK polyomavirus (BKPyV) is a major complication in kidney transplant recipients (KTR), for whom no specific antiviral therapy is available. Modulation of immunosuppressive therapy results in virus clearance in most KTR with BKPyV DNAemia (controllers), but a significant minority fail to clear the virus (non-controllers). Here, we adapt LIBRA-seq, which links antibody sequence data to antigen specificity, to intact viral capsids of the four BKPyV genotypes to study and compare BKPyV-specific B-ce...
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BackgroundRecent global outbreaks of Mpox have posed significant diagnostic challenges, particularly in resource-limited settings. Conventional diagnostic methods are often inaccessible due to cost, logistical constraints, or lack of trained personnel. These limitations highlight the urgent need for alternative, scalable diagnostic strategies. This study explored the application of machine learning (ML) classifiers trained on clinical symptom data as a rapid, cost-effective tool for Mpox detecti...
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BackgroundCandidemia is a rare but life-threatening bloodstream infection that remains difficult to predict using conventional risk stratification approaches, highlighting the need for improved predictive strategies. As a result, empiric antifungal therapy is often delayed even in high-risk patients. MethodsWe developed a deep learning model (PyTorch_EHR) to predict 7-day candidemia risk by using electronic health record data from two large cohorts (Houston Methodist Hospital System [HMHS] and ...