Pathogens

BackgroundInfections are the leading cause of non-relapse mortality in pediatric hematopoietic cell transplant (HCT) recipients. Up to 90% of bacteremias in these patients originate from gut microbiome organisms. However, selection for resistance genes, such as Extended-spectrum {beta}-lactamase (ESBL), in these patients gut microbiomes remains poorly understood. MethodsStools were prospectively collected from pediatric HCT recipients at multiple centers (n=133 patients, five centers) on the da...

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...

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...

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...

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...

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 ...

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...

BackgroundVaccination is a key measure to prevent severe influenza in adults aged [≥]80 years, who experience the highest burden of respiratory and cardiovascular complications. Because immunosenescence reduces the effectiveness of standard-dose vaccines (SD-IIV), enhanced formulations such as high-dose vaccines (HD-IIV) are recommended in the elderly. Real-world data on their effectiveness in adults aged [≥]80 years remain scarce. AimTo quantify the relative vaccine effectiveness (rVE) o...

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...

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...

BACKGROUNDOn 14 August 2024, WHO Director-General declared a public health emergency of international concern (PHEIC) following a sharp increase in mpox cases linked to the emergence of monkeypox virus (MPXV) clade Ib. We characterise imported and autochthonous cases of MPXV clade I reported in the WHO European Region since August 2024. METHODSBetween 14 August 2024 and 23 November 2025, we collected key information of MPXV clade I infections reported by member states of the WHO European Region...

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...

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...

Deaths due to diarrhea among children younger than five have been rapidly decreasing, from an estimated 484,781 in 2010 to 245,966 in 2021. A report by the International Livestock Research Institute in 2012 found that the top 13 most important zoonoses were responsible for 2.2 million human deaths. Questions remain whether the benefits of animal ownership outweigh the potential harms of being exposed to potentially deadly zoonotic pathogens. This study uses national surveys to assess the associa...

Since 2014, Cubas National Tuberculosis Control and Elimination Program (PNCET, acronym in Spanish) has been using the Xpert(R) MTB/RIF technique (Cepheid, Sunnyvale, CA, USA) for rapid molecular diagnosis of tuberculosis (TB). Due to financial limitations and difficult access to kits and cartridges (both of which are of U.S. origin), this test is only intended for prioritized vulnerable groups. Thus, only one third of the cases reported annually are diagnosed by rapid tests, as an initial techn...

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...

Over-the-counter (OTC) lateral flow tests for respiratory viruses have newly emerged since the beginning of the coronavirus disease 2019 (COVID-19) pandemic and are increasingly available to consumers. While all marketed tests have met standards for Emergency Use Authorization (EUA), De Novo classification or 510(k) clearance, limited data are available to inform consumers of their relative performance. We performed a head-to-head benchtop analytical assessment of OTC tests available for purchas...

According to the 2021 Global Burden of Diseases Study, diarrhea contributed to an estimated 340,429 deaths among children younger than five years old and an estimated 245,966 deaths in sub-Saharan Africa specifically. Some efforts to reduce the burden of diarrhea in Africa have focused on animal fecal contamination, particularly during extreme precipitation events (EPEs). A focus has been the concentration-dilution hypothesis, which is centered on EPEs immediately following dry periods. The sou...

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...

ObjectiveThe rapid availability of phenotypic antimicrobial susceptibility results is crucial for the timely detection of multidrug-resistant Gram-negative organisms and for guiding optimized treatment strategies. Recently, novel methods have been introduced that enable direct antimicrobial susceptibility testing (AST) from positive blood cultures. However, their performance has not yet been systematically compared in head-to-head evaluations. This study aimed to assess the analytical performanc...