Clinical Microbiology Reviews最新文献

{"title":"Invasive non-typhoidal <i>Salmonella</i> disease in the vaccine-development era: diagnostic blind spots, antimicrobial resistance, genomic transmission, and prevention.","authors":"Samweli Y Bahati, Reuben S Maghembe","doi":"10.1128/cmr.00201-26","DOIUrl":"https://doi.org/10.1128/cmr.00201-26","url":null,"abstract":"<p><p>SUMMARYInvasive non-typhoidal <i>Salmonella</i> (iNTS) disease is a severe bloodstream and focal invasive infection caused by non-typhoidal serovars of <i>Salmonella enterica</i>, especially <i>S</i>. Typhimurium and <i>S</i>. Enteritidis. Its clinical importance is disproportionate to its routine visibility because disease often presents as undifferentiated fever, sepsis, meningitis, severe anaemia-associated deterioration, recurrent bacteraemia, or focal infection, while definitive recognition depends on blood or other sterile-site microbiology. Global estimates indicate substantial mortality, but the true incidence remains uncertain because blood-culture access, prior antimicrobial exposure, specimen volume, and surveillance intensity vary widely. The vaccine-development era has intensified the need for a unified clinical microbiology framework. Prevention of invasive disease requires host-risk recognition, laboratory-confirmed endpoints, antimicrobial susceptibility testing, lineage-aware genomic surveillance, reservoir assessment, and post-introduction systems able to detect residual disease, breakthrough infection, non-target serovars, lineage shifts, and resistant invasive clones. This narrative review synthesizes the clinical, immunological, genomic, diagnostic, antimicrobial resistance, and vaccine era evidence relevant to iNTS control. Emphasis is placed on immune evasion, macrophage survival, T-cell dysfunction, immunosuppressed hosts, diagnostic blind spots, treatment under uncertainty, and the integration of laboratory systems with surveillance and prevention policy.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0020126"},"PeriodicalIF":20.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and ecological significance of bacterial dormancy in human pathogens","authors":"Victor Bal,Thibault Meyer,Sabine Favre-Bonté,Ashley Shade","doi":"10.1128/cmr.00237-26","DOIUrl":"https://doi.org/10.1128/cmr.00237-26","url":null,"abstract":"SUMMARY Bacteria can enter a transient state of reduced metabolic activity to survive temporary unfavorable conditions. This phenomenon, sometimes referred to as dormancy, growth arrest, or quiescence, enables pathogen survival inside and outside of their host, with major clinical consequences for the management of infections. From spores to persister cells, these states associated with bacterial dormancy share molecular mechanisms for controlling cellular activity and for responding to related environmental signals. In this review, we provide a synthesis of the diversity of dormant states in human pathogenic bacteria and their pathophysiology within a unifying framework of a dormant-to-active spectrum. We highlight recent developments in therapeutic strategies targeting growth-arrested bacteria and shed light on the role of dormancy in pathogen dissemination and transmission across compartments under a global health perspective. Finally, we discuss the role of dormancy as a microbial trait that shapes virulence and infection dynamics over the course of evolution. Overall, this work seeks to provide new insights into the links between bacterial dormancy and latency in microbial pathogenesis while alleviating the semantic boundaries of the field.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"3 1","pages":""},"PeriodicalIF":36.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149090170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-emergence of <i>Brucella</i> species: epidemiology and pathogenesis.","authors":"Sadia Tamanna, Dong-Min Kim, Beomgi Lee, Choon-Mee Kim, You-Mi Lee","doi":"10.1128/cmr.00139-26","DOIUrl":"10.1128/cmr.00139-26","url":null,"abstract":"<p><p>SUMMARY<i>Brucella</i> spp. are highly adapted intracellular bacterial pathogens that remain a substantial global cause of zoonotic disease. The globally distributed species <i>Brucella melitensis</i>, <i>Brucella abortus</i>, <i>Brucella suis</i>, and <i>Brucella canis</i> account for the majority of human infections, reflecting their efficient transmission across animal hosts, and their exceptional capacity to survive and replicate within the intracellular niche. Although animal infections are often clinically silent, human brucellosis can exhibit persistent intracellular infection and relapsing fever. Growing genomic data highlight expanding species diversity, including <i>B. canis</i> and marine <i>Brucella</i>. Progress in elucidating the intracellular life cycle of <i>Brucella</i>, including the maturation of <i>Brucella</i>-containing vacuoles, immune evasion strategies, and the role of the type IV secretion system, has refined our understanding of disease pathogenesis across hosts. At the same time, expanding molecular surveillance, global minimum-spanning-tree analyses, and One Health epidemiology have clarified transmission pathways among livestock, dogs, wildlife, and humans, revealing both cross-species connectivity and geographical hotspots of emergence. Given the limitations of existing livestock vaccines and the absence of human or canine vaccines, diverse next-generation platforms are now advancing toward translational evaluation. Unlike prior reviews focused primarily on livestock brucellosis or classical species, this review integrates emerging canine and marine <i>Brucella</i> lineages with advances in genomics, intracellular pathogenesis, and next-generation vaccine strategies within a unified One Health framework. In this review, we synthesize global trends in <i>Brucella</i> species diversity, zoonotic emergence, mechanisms of intracellular pathogenesis, and the status of current and experimental vaccines, while highlighting the One Health interventions needed to disrupt transmission and advance toward comprehensive brucellosis control.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0013926"},"PeriodicalIF":20.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV therapeutics in 2026.","authors":"Danilo Bacic Lima, Yijia Li, Joseph N Cherabie, Carlos S Saldana","doi":"10.1128/cmr.00163-24","DOIUrl":"10.1128/cmr.00163-24","url":null,"abstract":"<p><p><b>SUMMARY</b>The treatment and prevention of HIV have undergone significant transformations in the 16 years since the last major review of HIV therapeutics published in ASM's <i>Journal of Virology</i> (A. M. N. Tsibris and M. S. Hirsch, J Virol 84:5458-5464, 2010, https://doi.org/10.1128/jvi.02524-09). First-generation antiretroviral medications, many now discontinued, have been replaced by integrase strand transfer inhibitor-based regimens that offer superior efficacy, higher genetic barriers to resistance, and the convenience of a single-tablet fixed-dose combination. Dolutegravir and bictegravir are now the anchors of most first-line therapies worldwide, and two-drug and nucleoside reverse transcriptase inhibitor (NRTI)-sparing strategies have emerged, allowing for simplification of treatment of patients who had been previously on complex regimens. The most consequential recent advance, though, has been the introduction of long-acting injectable medications, including cabotegravir-rilpivirine for treatment, standalone cabotegravir for pre-exposure prophylaxis (PrEP), and lenacapavir, a first-in-class capsid inhibitor for both treatment and PrEP. For people with multidrug-resistant HIV, new agents including fostemsavir, ibalizumab, and lenacapavir have made virologic suppression achievable in virtually all heavily treatment-experienced patients. An investigational and emerging pipeline that includes third-generation integrase inhibitors, nucleoside reverse transcriptase translocation inhibitors, maturation inhibitors, and broadly neutralizing antibodies promises further expansion of HIV therapeutic options. These advances, however, come with potential challenges, including emergent resistance to long-acting agents, metabolic consequences of lifelong therapy in an aging population, persistent inequities in global access to newer agents, and often insufficient safety data in pregnancy and breastfeeding. This review provides a clinical assessment of the current antiretroviral options, from legacy agents to investigational therapies, with attention to the resistance, implementation, and special population considerations that will shape HIV practice in the future.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0016324"},"PeriodicalIF":20.7,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A duty to act","authors":"Emily Sickbert-Bennett,Philip J. Rosenthal,Cesar A. Arias,Gonzalo M. Bearman,Paul E. Sax,Graeme Forrest,David P. Calfee,Romney M. Humphries,Stanley Maloy,Ravi Jhaveri,Ira Blader,Ashley Shade,Roger Bedimo,Cynthia L. Sears,Paul Katz,Barbara Resnick","doi":"10.1128/cmr.00302-26","DOIUrl":"https://doi.org/10.1128/cmr.00302-26","url":null,"abstract":"","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"59 1","pages":""},"PeriodicalIF":36.8,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148933742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new era of dermatophytes: emerging species, new risk factors, and taxonomic change","authors":"Richard C. Summerbell,Avrom S. Caplan,Victoria R. V. Cox,James A. Scott,Sarah E. Kidd","doi":"10.1128/cmr.00142-24","DOIUrl":"https://doi.org/10.1128/cmr.00142-24","url":null,"abstract":"SUMMARY The traditional landscape of dermatophyte infections has changed over the past decade. The emergence and global expansion of Trichophyton indotineae have highlighted the impact of irrational and uncontrolled antifungal and topical corticosteroid use, presented treatment challenges, and highlighted the deficiencies of currently available diagnostic methods. Trichophyton mentagrophytes genotype VII, which has until recently been associated with animal reservoirs, is now associated with human-to-human transmission and is frequently related to sexual transmission. Infections associated with emerging dermatophytes are notable for atypical presentations that may include widespread, inflamed lesions, terbinafine resistance, and frequent relapse. The classic presentation of tinea lesions is frequently obscured by the application of topical corticosteroids, leading to delays in clinical recognition, diagnosis, and appropriate treatment, perpetuating further misuse of topical medications. Deep or invasive dermatophytoses, including Majocchi’s granuloma, may occur in immunocompromised patients. The introduction of matrix-assisted laser desorption/ionization-time of flight mass spectrometry and molecular detection of dermatophytes has improved the diagnostic landscape for dermatophytes. However, currently, most assays do not specifically detect T. indotineae or T. mentagrophytes genotype VII, hindering the diagnosis and surveillance. Sequencing of the internal transcribed spacer (ITS) region is required for definitive identification. Terbinafine and azole resistance is common in T. indotineae and increasingly being reported for other species. While nomenclatural changes have been introduced and debated over many decades, the last decade has seen the introduction of new genera, e.g., Nannizzia, Paraphyton, and Lophophyton . An overview of currently recognized dermatophyte species, complexes, and genera is presented here, describing phylogenetic, ecological, and biochemical relatedness. The ethical conundrum of the name Trichophyton indotineae is also discussed.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"65 1","pages":""},"PeriodicalIF":36.8,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148933937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of the penile microbiome in female sex partner risk of bacterial vaginosis and sexually transmitted infections: a narrative review.","authors":"Supriya D Mehta","doi":"10.1128/cmr.00331-25","DOIUrl":"10.1128/cmr.00331-25","url":null,"abstract":"<p><p>SUMMARYThe penile microbiome (PMB) can be dominated by skin-associated bacteria (e.g., <i>Corynebacterium</i>, <i>Staphylococcus</i>, and <i>Streptococcus</i>) or by anaerobic bacteria that are associated with bacterial vaginosis (BV), and is influenced by male circumcision status, female partner vaginal microbiome (VMB), BV status, condom use, and antibiotic use. Penile bacteria that are associated with BV and genital mucosal inflammation are associated with men's risk of HIV and STIs. In the few studies that simultaneously evaluate the penile and vaginal microbiome in sex partners, specific taxa are highly correlated, with evidence for bi-directional transmissibility. BV-associated taxa in the PMB are associated with increased risk of BV and STIs in female sex partners. Emergent trials demonstrate that antimicrobial treatment in men can reduce penile anaerobic bacteria and female sex partner's risk of BV recurrence. However, data are lacking on factors influencing penile-vaginal bacterial exchangeability, the durability of bacterial exchange, and the conditions under which exchange may lead to increased risk of adverse outcomes in the index or partner. Optimal and non-optimal PMB have not been defined. Assessment of PMB composition and function across the life course is needed. Association of PMB with intrinsic host factors (genetics and endogenous hormones) is lacking; association with behavioral and lifestyle factors is limited. Addressing these gaps may lead to the development of assays to facilitate screening and monitoring after therapeutic interventions in men and female partners, or the development of therapeutics for optimizing PMB. Studies are needed to refine and develop new treatment and counseling guidelines for men and their sexual partners.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0033125"},"PeriodicalIF":20.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of fungi on epithelial homeostasis and role in inflammatory diseases.","authors":"Liam F Peterson, Jingyi Wang, Neil A R Gow, Salomé LeibundGut-Landmann, Matthew G Brewer","doi":"10.1128/cmr.00319-25","DOIUrl":"10.1128/cmr.00319-25","url":null,"abstract":"<p><p>SUMMARYThe skin harbors a diverse fungal community that contributes to both epidermal homeostasis and inflammatory disease. Historically, studies of cutaneous fungi focused primarily on opportunistic infections in immunocompromised hosts. Advances in sequencing technologies and metagenomic analyses have revealed that commensal yeasts of the skin microbiome likely influence host physiology and cutaneous disease severity. In this review, we summarize the current knowledge of host-fungal interactions at the skin epithelium, with particular emphasis on the yeast genera <i>Malassezia</i> and <i>Candida</i>. We discuss how fungal colonization shapes epidermal biology through direct interactions with keratinocytes and immune cells, highlighting fungal virulence factors such as secreted proteases and candidalysin, as well as host-sensing pathways. We further examine how these interactions contribute to inflammatory skin diseases, particularly atopic dermatitis and psoriasis, and how fungi participate in polymicrobial networks with bacteria and viruses to alter susceptibility to infection. Finally, we discuss how emerging therapeutic strategies change the fungal composition on skin. These advances suggest the importance of fungi as active regulators of skin immunity and emphasize key knowledge gaps that need to be addressed in future studies to better understand how they contribute to cutaneous diseases.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0031925"},"PeriodicalIF":20.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From decline to resurgence: current perspectives on <i>Mycoplasma pneumoniae</i>.","authors":"Ying Liu, Qing Ye","doi":"10.1128/cmr.00051-26","DOIUrl":"10.1128/cmr.00051-26","url":null,"abstract":"<p><p><b>SUMMARY</b><i>Mycoplasma pneumoniae</i> pneumonia (MPP) is an acute respiratory infection caused by <i>Mycoplasma pneumoniae</i> (MP) and constitutes the primary cause of community-acquired pneumonia (CAP) among children aged 5 years and older in China. The clinical manifestations of MP-associated respiratory disease in children are diverse, ranging from mild upper respiratory symptoms to life-threatening pneumonia. Notably, during the implementation of nonpharmaceutical interventions (NPIs) aimed at curbing SARS-CoV-2 transmission, there was a significant decline in MP infection rates. However, a pronounced global resurgence of MP infections was documented in 2023-2024. The increasing global prevalence of macrolide resistance, particularly in China, coupled with limited alternative antibiotic options for children, increasing rates of coinfections, and the absence of a preventive vaccine, collectively exacerbate treatment challenges and increase the disease burden. Furthermore, the insufficient availability of MP nucleic acid testing and antimicrobial resistance surveillance in primary healthcare settings, coupled with the absence of a comprehensive epidemiological monitoring network, results in a vicious public health cycle. Recent advances and emerging genomic data have provided new insights into its pathogenesis and clinical management. Therefore, in this narrative review, we aim to (i) synthesize the current understanding of the etiological characteristics of MP and the present status of MPP diagnosis and treatment; (ii) analyze recent advances and drivers behind the global resurgence of MP infections; and (iii) propose integrated prevention and control strategies to increase the recognition of MPP and prevent unanticipated outbreaks.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0005126"},"PeriodicalIF":20.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancement of LAMP technologies for rapid and accurate diagnosis of infectious diseases.","authors":"Ryan Chaffee, Nabil Royez, Jack Burke-Gaffney, Paul Williamson, Archie Shchemialiou, Banchamlak Tegegne, Shoaib Ashraf, L Ricardo Castellanos, Biniyam Mezgebo, Dylan R Pillai","doi":"10.1128/cmr.00079-24","DOIUrl":"10.1128/cmr.00079-24","url":null,"abstract":"<p><p>SUMMARYLoop-mediated isothermal amplification (LAMP) is a type of isothermal nucleic acid amplification test (NAAT). Compared to more traditional NAATs, like polymerase chain reaction (PCR), LAMP is run at one consistent temperature, utilizes four to six primers, and uses <i>Bst</i> polymerase. Some advantages that are provided by these differences are that LAMP has lower equipment requirements, resiliency to common PCR inhibitors, and a rapid time to result. Unfortunately, some disadvantages are also present due to these differences, such as more challenging primer design, reduced multiplexing capability, and difficulty with quantitation. Due to its unique characteristics, LAMP has proven to be an attractive option for molecular diagnostics in resource-limited, point-of-care, and near-patient testing settings. However, its adoption in clinical settings remains limited compared to its widespread use in research. In this review, we cover various detection methods within LAMP, recent advancements including extraction, multiplexing, and quantification, as well as key clinical applications of LAMP from a syndromic perspective. We also explore the commercial potential of LAMP and how it can be leveraged in resource-constrained settings and clinical laboratories, especially where early, affordable, and rapid diagnosis is essential.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0007924"},"PeriodicalIF":20.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}