Clinical Microbiology Reviews最新文献

{"title":"Leptospira-host interactions: advancing next-generation vaccines and diagnostics.","authors":"Bothammal Palanisamy,Syed M Faisal","doi":"10.1128/cmr.00373-25","DOIUrl":"https://doi.org/10.1128/cmr.00373-25","url":null,"abstract":"SUMMARYLeptospirosis, a widespread zoonotic disease caused by pathogenic Leptospira species, remains a major public health challenge, particularly in tropical and subtropical regions. Despite advances in understanding Leptospira biology and pathogenesis, effective disease control continues to be limited by the lack of rapid, early diagnostics, and broadly protective vaccines. This review comprehensively examines recent progress in deciphering Leptospira-host interactions, with emphasis on key virulence factors, immune-evasion mechanisms, and host immune responses that influence disease outcomes. Particular focus is placed on the molecular and cellular basis of adhesion, invasion, immune modulation, and persistent colonization. We further discuss the limitations of current vaccines and diagnostic approaches, and highlight how emerging technologies, including pan-genomics, proteomics, reverse vaccinology, immunoinformatics, and omics-based antigen discovery, are facilitating the development of next-generation vaccines and diagnostics. Finally, we outline major translational challenges and future perspectives for improving clinical management, surveillance, and prevention of leptospirosis. The concepts discussed in this review may also provide broader insights into vaccine and diagnostic development for other zoonotic bacterial infections.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"40 4 1","pages":"e0037325"},"PeriodicalIF":36.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148462469","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":"Twenty-five years of human metapneumovirus research.","authors":"Elhadji Birane Mboup,Julia Dubois,Marie-Ève Hamelin,Manuel Rosa-Calatrava,Guy Boivin","doi":"10.1128/cmr.00330-25","DOIUrl":"https://doi.org/10.1128/cmr.00330-25","url":null,"abstract":"SUMMARYThe year 2026 marks the 25th anniversary of the discovery of human metapneumovirus (HMPV), which belongs to the metapneumovirus genus within the Pneumoviridae family. The respiratory syncytial virus (RSV), discovered in 1956, is a close relative of HMPV belonging to the same family but to a different genus. In this article, we review key past findings related to HMPV infection, highlighting the differences with RSV. In addition, we specifically discuss current research areas pertaining to changing epidemiology, clinical burden, host response, as well as therapeutic and prophylactic modalities now in clinical trials. Additional research on HMPV is needed to contain this important respiratory virus.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"58 1","pages":"e0033025"},"PeriodicalIF":36.8,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148415863","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":"Diagnostic challenges in re-emerging rickettsioses: why current tools fall short.","authors":"Yaawar Bashir Mir,Tasaduq Manzoor,Danish Mushtaq,Ashaq Hussain Najar,Fizalah Kawoosa,Dhiraj Bhatia,Syed Mudasir Qadri,Farhana Siraj,Syed Mudasir Ahmad","doi":"10.1128/cmr.00020-26","DOIUrl":"https://doi.org/10.1128/cmr.00020-26","url":null,"abstract":"SUMMARYRickettsial diseases, encompassing scrub typhus, spotted fever group rickettsioses, and typhus group rickettsioses, represent a significant and escalating public health threat worldwide, particularly in the Asia-Pacific and sub-Saharan African regions. Despite their high morbidity and potential for fatal outcomes if left untreated, these infections remain notoriously underdiagnosed due to their nonspecific clinical presentation, which frequently overlaps with other acute undifferentiated febrile illnesses (AUFIs) such as dengue, malaria, and leptospirosis. This review evaluates the evolving diagnostic landscape, highlighting the severe limitations of conventional methods: the Weil-Felix test lacks necessary specificity, while the gold standard indirect immunofluorescence assay (IFA) is primarily retrospective due to delayed seroconversion. Molecular diagnostics, particularly multiplex polymerase chain reaction (mPCR), have emerged as a critical advancement, enabling early, species-specific identification during the acute phase of infection when doxycycline therapy is most effective. We further explore the paradigm shift toward syndromic molecular panels, such as the TaqMan Array Card (TAC), which facilitate simultaneous screening for multiple AUFI pathogens. Emerging platforms, including digital PCR (dPCR) for absolute quantification and CRISPR-Cas-based point-of-care (POC) systems (SHERLOCK and DETECTR), offer promising solutions for low-resource settings. Finally, this review underscores the necessity of integrating molecular surveillance within a One Health framework and utilizing artificial intelligence (AI) to address technical and implementation barriers. Overcoming these challenges is essential for transforming rickettsial diagnosis from a reactive to a proactive strategy, ultimately reducing the global burden of these neglected zoonoses.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"41 1","pages":"e0002026"},"PeriodicalIF":36.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148365608","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":"Current progress in developing mRNA-lipid nanoparticle vaccines against human bacterial pathogens.","authors":"Brody Pullinger,Nichaela Harbison-Price,Ismail Sebina,Jack Na,Gabrielle T Belz,Mark J Walker","doi":"10.1128/cmr.00138-26","DOIUrl":"https://doi.org/10.1128/cmr.00138-26","url":null,"abstract":"SUMMARYThe messenger RNA (mRNA)-lipid nanoparticle (LNP) vaccine platform is the newest tool in the vaccination arsenal for combating infectious diseases, rare genetic diseases, and cancer. Since 2020, major advances in preclinical and clinical studies have demonstrated the efficacy of mRNA-LNP vaccines against viral pathogens and in cancer. However, studies investigating the efficacy of mRNA-LNP vaccines against bacterial pathogens remain sparse due to substantial bacterial vaccine-specific challenges. Here, we highlight key challenges impeding the development of mRNA-LNP vaccines against human bacterial pathogens, the advantages that can be gained by utilizing the mRNA-LNP platform for bacterial vaccines, and progress toward the development of mRNA-LNP vaccines against bacterial infections.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"35 1","pages":"e0013826"},"PeriodicalIF":36.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148365615","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":"The gut microbiome and colorectal cancer.","authors":"Matthew Dietz,Subbaya Subramanian,Christopher Staley","doi":"10.1128/cmr.00332-25","DOIUrl":"https://doi.org/10.1128/cmr.00332-25","url":null,"abstract":"SUMMARYColorectal cancer (CRC) is a significant global health concern that is growing in prevalence, especially in younger populations. The gut microbiome is an increasingly recognized factor in the development and progression of numerous diseases, including CRC. This review explores the current research on the causal relationship between the microbiome and CRC, including the strengths and limitations of the current models for studying this complex interaction. We then delve into key microbial metabolites and their effects on host signaling pathways in the context of CRC and highlight specific bacterial species with direct links to CRC development and progression. Existing microbiota-targeted therapies such as pre- and pro-biotics and fecal microbiota transplantation are described, as well as innovative microbiome-focused strategies that are currently in development, like quorum quenching. Finally, we address the major challenges in the field, such as conflicting research findings and the need for a systems-level, multi-omic approach to describe the intertwined and bidirectional host-microbe interactions.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"30 1","pages":"e0033225"},"PeriodicalIF":36.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148342517","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":"Interactions between long-acting antiretrovirals and opioids: a call for clinical awareness.","authors":"Candy Carbajal, Florida Owens, Dileepkumar Veeragoni, Myosotys Rodriguez, Francisco Fernandez-Lima, Adel Nefzi, Shilpa Buch, Nazira El-Hage","doi":"10.1128/cmr.00395-25","DOIUrl":"10.1128/cmr.00395-25","url":null,"abstract":"<p><p>SUMMARYThis review summarizes potential drug-drug interactions (DDIs) between long-acting antiretrovirals (LAAs) and opioids, focusing on pharmacodynamics (PD), pharmacokinetics (PK), and side effects related to absorption, distribution, metabolism, and excretion (ADME). It also covers dysregulation in epigenetics and in the immune system. A comprehensive literature review was performed using PubMed and Google Scholar, along with data from the Liverpool HIV Drug Interactions Database, to evaluate pharmacokinetic interactions between LAA drugs, such as cabotegravir, rilpivirine, lenacapavir, and dapivirine, with opioids used in clinical settings, including morphine, tramadol, oxycodone, and codeine; medications for opioid use disorder (MOUD), such as methadone and buprenorphine; and the illicit opioids, including fentanyl and heroin. The review highlights key factors increasing DDI risk and discusses clinical considerations for managing preexposure prophylaxis (PrEP) or antiretroviral therapy (ART) in persons who use opioids. Lastly, it proposes research strategies for studying DDIs, including the use of animal models, physiologically based pharmacokinetic (PBPK) models, and clinical trials.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0039525"},"PeriodicalIF":20.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431176","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":"Revisiting the natural history of Jorge Lobo's disease: a mycological enigma spanning unresolved taxonomy, uncertain transmission, and inadequate therapy.","authors":"Marcus de Melo Teixeira, Franciely Gomes Gonçalves, Luiza Alves Vianna, Bernardo Guerra Tenório, Lucas Gomes de Brito Alves, Rui Rafael Durlacher, Mario Roberto de Sousa Trindade, João Paulo Romualdo Alarcão Bernardes, Alex Panizza Jalkh, Lígia Lins Frutuoso, Luiza Ohana Harada, Daniel Moreira Alves da Silva, Allan Mascarenhas Amaral Barroso, Eduardo Alves, Fernanda Dockhorn Costa Johansen, Maiko Luis Tonini, Gil Benard, Maria Sueli Soares Felipe, Patrícia Sammarco Rosa, Marcos César Florian, Marines Dalla Valle Martino, João Nobrega de Almeida Júnior","doi":"10.1128/cmr.00302-25","DOIUrl":"10.1128/cmr.00302-25","url":null,"abstract":"<p><p>SUMMARYJorge Lobo's disease (JLD) is a chronic cutaneous and subcutaneous mycosis endemic to the Amazon Basin and tropical rainforests of Latin America. Despite more than a century of study, the disease remains underrecognized, poses significant diagnostic challenges, and is often therapeutically refractory. Here, we synthesize historical, clinical, and ecoepidemiological evidence; provide a practical diagnostic approach; and highlight unresolved questions. Clinically, JLD presents as slowly progressive keloid-like nodules and plaques on exposed areas. Diagnosis relies on direct microscopy and histopathology showing chains of thick-walled yeast-like cells connected by narrow-neck budding; culture is not feasible, and molecular assays are rarely available outside reference centers. We contrast JLD with key mimickers (cutaneous leishmaniasis, chromoblastomycosis, leprosy, atypical mycobacterioses, and non-infectious lesions such as keloid scars) and summarize current management options, emphasizing when surgery alone suffices and when prolonged azole therapy should be considered. From an ecoepidemiological perspective, historical settlement patterns, occupational exposures, and environmental disturbance in humid forest biomes appear to have amplified human contact with putative environmental reservoirs. New phylogenomic data position <i>Paracoccidioides lobogeorgii</i> as an early-diverging lineage within <i>Paracoccidioides</i>, refining prior MLST-based inferences. We outline practical surveillance steps to address under-ascertainment, standardized case definitions, sentinel reporting, and laboratory quality assurance and propose research priorities spanning environmental detection, host-pathogen interactions, and therapeutic evaluation. We contextualize the disease within broader frameworks of fungal emergence, structural neglect, and environmental disruption, arguing that revisiting JLD is not merely retrospective but a necessary scientific and ethical priority.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0030225"},"PeriodicalIF":20.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940407","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":"Infection prevention and control in low- and middle-income countries: policy, practice, and implementation challenges in sub-Saharan Africa.","authors":"Uduak Okomo, Felicity Fitzgerald, Nicholas Feasey, Shaheen Mehtar, Angela Dramowski","doi":"10.1128/cmr.00142-22","DOIUrl":"10.1128/cmr.00142-22","url":null,"abstract":"<p><p>SUMMARYInfection prevention and control (IPC) programs are essential for safe healthcare; yet, implementation across sub-Saharan Africa remains constrained by chronic underfunding, weak water, sanitation, and hygiene (WASH) systems, limited laboratory capacity, and shortages of trained staff. Healthcare-associated infections (HCAIs) are presumed common, underreported, and often severe, with a disproportionate burden among hospitalized neonates and postpartum women, and they pose substantial risks to healthcare workers during outbreaks. Gram-negative pathogens such as <i>Klebsiella</i>, <i>Escherichia coli</i>, <i>Pseudomonas,</i> and <i>Acinetobacter</i> predominate, alongside methicillin-resistant <i>Staphylococcus aureus</i>, with widespread resistance to third-generation cephalosporins and other key antibiotics linking HCAIs directly to the region's antimicrobial resistance crisis. National and regional IPC policy frameworks have expanded, but facility-level implementation lags, reflected in patchy surveillance, weak accountability, and unreliable supplies of alcohol-based hand rub (ABHR), personal protective equipment, environmental cleaning materials, and core WASH and ventilation infrastructure. Evidence from sub-Saharan Africa shows that pragmatic multimodal strategies, locally produced ABHR, infrastructure designed to facilitate hand hygiene, role-specific training for clinical and non-clinical staff, and inclusive approaches involving families can improve practices and outcomes when supplies and supervision are sustained. A whole-system approach is required, prioritizing fit-for-purpose surveillance, stronger WASH and waste management services, development of an IPC workforce, and support for African-led innovation, including local manufacturing and context-specific decision-support tools. Implementing these actions through community engagement, empowered leadership at all levels, and sustainable financing is critical to reducing HCAIs, slowing antimicrobial resistance, and strengthening healthcare quality and resilience in sub-Saharan Africa.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0014222"},"PeriodicalIF":20.7,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13255549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940436","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":"Implementation of pathogen genomics in clinical microbiology laboratories.","authors":"Andrew P Gador-Whyte,Norelle L Sherry,Anna Brischetto,Patiyan Andersson,Katherine A Bond,Sebastiaan J van Hal,Patrick N A Harris,Benjamin P Howden, ","doi":"10.1128/cmr.00177-25","DOIUrl":"https://doi.org/10.1128/cmr.00177-25","url":null,"abstract":"SUMMARYPathogen genomics, including whole-genome sequencing (WGS) and clinical metagenomics, is a transformative technology increasingly being implemented in clinical microbiology, including in hospital laboratories. Pathogen genomics can improve the control of healthcare-associated infections, provide rapid infection diagnosis, and could enable replacement of laborious microbiology tests. To date, real-world implementation of pathogen genome sequencing has primarily been limited to public health laboratories, but sequencing in the clinical microbiology setting has the potential to provide advantages, including turnaround time and ability to focus on local priorities. In this review, we consider the factors that represent barriers to, and potential enablers of, the implementation of pathogen genomics in clinical microbiology, including the availability of funding and genomics-trained staff. We outline key use cases and implementation models of pathogen genomics in clinical microbiology and suggest a broad framework for labs commencing sequencing. Finally, we consider future opportunities, including direct-from-specimen sequencing, the role of machine learning in genomics analysis, and the application of pathogen genomics to clinical decision support.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"25 1","pages":"e0017725"},"PeriodicalIF":36.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751316","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":"Global emergence and rapid spread of Candidozyma auris (syn. Candida auris): epidemiology, biology, and antifungal resistance.","authors":"Jian Bing,Shuaihu Li,Lingyu Ji,Han Du,Nora M Shamoon,Clarissa J Nobile,Guanghua Huang","doi":"10.1128/cmr.00394-25","DOIUrl":"https://doi.org/10.1128/cmr.00394-25","url":null,"abstract":"SUMMARYThe emerging fungal pathogen Candidozyma auris (syn. Candida auris; C. auris) has attracted considerable attention from the scientific, clinical, and public health communities due to its multidrug resistance, environmental persistence, and high transmissibility. Since its first description in Japan in 2009, C. auris has spread rapidly worldwide, with a marked acceleration following the coronavirus disease 2019 (COVID-19) pandemic. As of December 2025, 84,941 colonization or infection cases have been reported across 82 countries spanning 6 continents. In this review, we summarize the current knowledge of the biology and global epidemiology of C. auris. We first examine its taxonomy, proposed origins, and key biological, genetic, and phenotypic characteristics, with particular emphasis on factors underlying environmental persistence, transmission dynamics, antifungal resistance, and virulence. Drawing on published literature and publicly available surveillance data from national public health authorities worldwide, we provide an updated overview of the global epidemiological landscape and evolving transmission patterns of C. auris. Finally, we discuss potential strategies to mitigate the continued and escalating global spread of this emerging multidrug-resistant fungal pathogen.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"22 1","pages":"e0039425"},"PeriodicalIF":36.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147731558","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}