Infectious Disease Reports最新文献

{"title":"Chromosomal Mechanisms of Colistin Resistance in Clinical Isolates of Carbapenem-Resistant <i>Klebsiella pneumoniae</i> from a Tunisian Tertiary-Care Hospital.","authors":"Zaineb Hamzaoui, Hajer Kilani, Alain Ocampo-Sosa, Sana Ferjani, Elaa Maamar, Lamia Kanzari, Ahmed Fakhfakh, Amel Rehaiem, Luis Martínez-Martínez, Ilhem Boutiba Ben Boubaker","doi":"10.3390/idr18030042","DOIUrl":"10.3390/idr18030042","url":null,"abstract":"<p><strong>Background/objectives: </strong>Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP) is a major nosocomial pathogen. Although newer agents have reduced colistin use in high-income countries, this polymyxin remains important in many low- and middle-income settings. Colistin resistance in <i>K. pneumoniae</i> is most commonly associated with chromosomal alterations affecting the MgrB-PhoPQ pathway, or with plasmid-mediated <i>mcr</i> genes. This study aimed to investigate chromosomally mediated colistin resistance in CRKP clinical isolates from a Tunisian tertiary hospital.</p><p><strong>Methods: </strong>Between 2010 and 2015, 317 non-duplicate CRKP isolates were collected at Charles Nicolle Hospital, Tunis. Colistin MICs were determined by broth microdilution. Phenotypic tests and PCR characterized carbapenemases, extended-spectrum β-lactamases, AmpC, plasmid-mediated quinolone resistance, <i>mcr</i> and virulence genes. Porins (OmpK35/OmpK36) and the <i>mgrB</i>, <i>phoP</i> and <i>phoQ</i> loci were analyzed by SDS-PAGE and sequencing. Clonal relatedness was assessed by ERIC-PCR and multilocus sequence typing. We additionally compared colistin-resistant isolates with a panel of colistin-susceptible CRKP controls and assessed phenotypic stability after serial passages without colistin.</p><p><strong>Results: </strong>Five isolates (1.6%) were colistin-resistant. All were multidrug-resistant, produced OXA-48, and two also carried NDM-1. The isolates belonged to five distinct sequence types, including high-risk clones (ST11, ST101, ST147). No <i>mcr</i> genes were detected. Four isolates carried disruptive mutations in <i>mgrB</i>, and the remaining strain harbored inactivating mutations in both <i>phoP</i> and <i>phoQ</i> with an intact <i>mgrB</i>. Truncating alterations in PhoP/PhoQ and frequent loss or truncation of OmpK35/OmpK36 were observed. No <i>mgrB</i>/<i>phoP</i>/<i>phoQ</i> alterations were detected among colistin-susceptible controls, and colistin MICs remained stable after 7 days of drug-free passaging.</p><p><strong>Conclusions: </strong>In Tunisian CRKP, colistin resistance was associated with chromosomal alterations, predominantly involving disruption of the MgrB-PhoPQ pathway, in the absence of <i>mcr</i> genes. These mechanisms in both high-risk and emerging sequence types underscore the adaptability of CRKP and the need for surveillance where colistin remains an important therapeutic option.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Manifestations Documented in Patients with Lyme Disease: Clinical Presentation, Management Strategies, and Outcomes.","authors":"Luis Antonio Cortes Islas, Priscila Mishelle Bartolo Gomez, Nora Denice Cuevas Obispo, Ayelen Xicohtencatl Muñoz, Lao Yuling Lopez Lucero, Juan Pablo Ramirez Hinojosa","doi":"10.3390/idr18030040","DOIUrl":"10.3390/idr18030040","url":null,"abstract":"<p><strong>Background/objectives: </strong>Lyme disease is a tick-borne zoonosis caused by <i>Borrelia burgdorferi</i> that can affect multiple organ systems. Although cardiovascular involvement is considered uncommon, it may lead to severe and potentially life-threatening complications, particularly conduction disturbances and inflammatory cardiac conditions. This review aims to describe the spectrum of cardiovascular manifestations documented in patients with Lyme disease, focusing on clinical presentation, diagnostic approaches, management strategies, and reported outcomes.</p><p><strong>Methods: </strong>A narrative literature review was performed using PubMed, MEDLINE, and Google Scholar. Articles published between January 2000 and July 2025 in English or Spanish were screened. Eligible studies included original research articles, systematic and narrative reviews, case series, and case reports describing confirmed Lyme disease with cardiovascular involvement. A total of 30 studies were included. The available evidence was predominantly based on case reports and small case series, with considerable heterogeneity in study design, patient populations, and reported outcomes. Data on clinical manifestations, diagnostic methods, treatment strategies, and outcomes were extracted and synthesized.</p><p><strong>Results: </strong>Atrioventricular conduction disturbances were the most frequently reported cardiovascular manifestation, ranging from first-degree block to complete heart block, often presenting abruptly with syncope or bradycardia. Other reported manifestations included atrial and ventricular arrhythmias, myocarditis, pericarditis, myopericarditis, valvular endocarditis, aortitis, and vasculitis. Diagnosis relied on a combination of clinical suspicion, epidemiologic exposure, serologic testing, electrocardiographic monitoring, and cardiac imaging. Most patients were treated with antimicrobial therapy, commonly intravenous ceftriaxone followed by oral doxycycline, with temporary pacemaker support required in selected cases. Overall, clinical outcomes were favorable when treatment was initiated promptly.</p><p><strong>Conclusions: </strong>Cardiovascular involvement in Lyme disease, although infrequent, encompasses a broad clinical spectrum with potentially serious consequences. Early recognition, appropriate diagnostic evaluation, and timely antimicrobial therapy are essential to ensure reversibility of cardiac manifestations and favorable outcomes. However, the available evidence is limited by heterogeneity and the predominance of low-level-evidence studies.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Albicans <i>Candida</i> Peritonitis in Peritoneal Dialysis: Species Distribution, Management, and Outcomes-A Systematic Case-Based Review.","authors":"John Dotis, Athina Papadopoulou, Maria Fourikou, Marianna Papakonstantinou, Ioustini Kalaitzopoulou, Charalampos Antachopoulos","doi":"10.3390/idr18030041","DOIUrl":"10.3390/idr18030041","url":null,"abstract":"<p><strong>Background/objectives: </strong>Fungal peritonitis is a severe complication of peritoneal dialysis (PD) associated with catheter removal, technique failure, and increased mortality. Although <i>Candida albicans</i> was traditionally the predominant pathogen, non-albicans <i>Candida</i> (NAC) species are increasingly reported. This review summarizes the epidemiology and outcomes of PD-associated NAC peritonitis.</p><p><strong>Methods: </strong>A systematic review was performed following PRISMA guidelines. PubMed/MEDLINE, Scopus, and Google Scholar were searched (January 1990-March 2026) for NAC peritonitis studies. Case reports and series with species-level identification were included.</p><p><strong>Results: </strong>31 studies met the inclusion criteria, comprising 25 individual case reports and 6 case series, totaling 89 NAC isolates. <i>Candida parapsilosis</i> was the most frequently reported species (<i>n</i> = 50), followed by <i>Candida tropicalis</i> (<i>n</i> = 15). Other pathogens included <i>Candida glabrata</i>, <i>Candida guilliermondii,</i> and several rare NAC species. Fluconazole was the most commonly used initial antifungal therapy. Catheter removal was performed in most cases, with the majority of patients requiring transition to hemodialysis. Overall mortality was 20% among individual case reports vs. 24% across case series. Species-specific differences were observed: <i>C. parapsilosis</i> and <i>C. guilliermondii</i> were generally associated with favorable outcomes, whereas infections involving <i>C. glabrata</i> and other emerging NAC species more frequently required treatment escalation and were linked to poorer outcomes.</p><p><strong>Conclusions: </strong>NAC species are an important cause of fungal peritonitis in PD patients and show considerable heterogeneity in clinical outcomes and antifungal susceptibility. Early species-level identification and prompt catheter removal remain essential for optimal management.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Pneumomediastinum, Subcutaneous Emphysema, and Pneumoperitoneum in RT-PCR-Confirmed Measles: A Pediatric Case Report.","authors":"Roberto Miguel Damián-Negrete, Alondra Denisse Hernández-Luna, Rocío Guadalupe Cano-Arias, Antonio Durán-Plaza, Judith Carolina De Arcos-Jiménez, Kathya Analí Rodríguez-González, Braulio Dazahel González-Flores, Pedro Iván Navarro-González, Jaime Briseno-Ramírez","doi":"10.3390/idr18030039","DOIUrl":"10.3390/idr18030039","url":null,"abstract":"<p><p>Measles remains a major global public health challenge as declining vaccination coverage fuels outbreaks worldwide. Although pneumonia is the most recognized respiratory complication, spontaneous air leak syndrome-including pneumomediastinum, subcutaneous emphysema, and pneumoperitoneum-is rarely documented. We report the case of a 9-year-old previously healthy girl with no documented measles-rubella vaccination who presented with fever, maculopapular exanthem, Koplik spots, and persistent cough. Measles was confirmed by both immunoglobulin M enzyme-linked immunosorbent assay and real-time reverse transcription polymerase chain reaction. She developed sudden cervicothoracic swelling and chest pain. Chest radiography revealed pneumomediastinum and subcutaneous emphysema; computed tomography confirmed extensive air leak including pneumoperitoneum. Flexible bronchoscopy and upper gastrointestinal endoscopy excluded structural airway and esophageal injury. Laboratory evaluation revealed elevated hepatic transaminases, gamma-glutamyl transferase, lactate dehydrogenase, and D-dimer. Conservative management with high-flow supplemental oxygen and clinical surveillance led to progressive resolution. The patient was discharged on hospital day three, asymptomatic and breathing room air. This case highlights the spectrum of air leak complications in measles and supports conservative management in hemodynamically stable pediatric patients when structural injury has been excluded.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13214823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HBV and the Microbiome-PubMed Database Literature Review.","authors":"Anna Marija Prince, Indra Zeltiņa, Aigars Reinis, Olga Valciņa, Angelika Krūmiņa","doi":"10.3390/idr18030038","DOIUrl":"10.3390/idr18030038","url":null,"abstract":"<p><strong>Objective: </strong>Hepatitis B virus (HBV) is a globally distributed infectious disease affecting the liver. This literature review aims to summarize all available relevant information on the PubMed database about HBV's connection to the microbiome and to consider possible treatment adjuncts.</p><p><strong>Materials and methods: </strong>Database used: PubMed. Keywords used: \"HBV\", \"Hepatitis B\", \"microbiome\". In the PubMed database, 179 research publications were identified using these keywords; 69 studies were excluded as they were irrelevant or retracted. Of the remaining, 110 were analyzed in this literature review, and four additional literature sources were used to supply background information and context. Information was summarized. The analysed studies in total included 14,814 participants (excluding animal studies), of whom 8564 were HBV-infected individuals.</p><p><strong>Results: </strong>Results characterizing abundance or decrease in specific bacterial, viral, and fungal species are heterogeneous; multiple studies support that the HBV patient oral and fecal microbiome is different from that in healthy controls (HCs) and varies throughout disease progression. The HBV seems to transform the microbiome negatively, leading to dysbiosis and decreased microbial diversity in most studies. Evidence links HBV microbiome changes with influence on HbeAg seroconversion, HBV-DNA load, metabolic pathways, liver cirrhosis, and hepatocellular carcinoma. The research proposes that members of microbiota could potentially promote or protect against liver injury in HBV. Four studies proposed that the plasma virome in HBV patients was primarily composed of members of the <i>Anelloviridae</i>. One study researched a parasite (<i>Entamoeba gingivalis</i>) in HBV patients. Two studies analyzed HBV patients' fungal profiles.</p><p><strong>Conclusions: </strong>Microbiota research, although promising, at the present moment is heterogeneous. HBV patients' microbiota is distinguishable from HCs, and multiple studies have tried to identify the HBV characteristic microbiome; however, more precise information is needed to draw conclusions. Fecal microbiota transplantation and probiotics have the potential to be therapy adjuncts for HBV patients, but more research is needed.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 3","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influenza A(H3N2) Subclade K (J.2.4.1): Molecular Characterization, Antigenic Divergence, and Global Spread During the 2025/26 Season.","authors":"Francesco Branda, Nicola Petrosillo, Giancarlo Ceccarelli, Fabio Scarpa, Marta Giovanetti, Massimo Ciccozzi","doi":"10.3390/idr18020037","DOIUrl":"10.3390/idr18020037","url":null,"abstract":"<p><p><b>Background:</b> Influenza A(H3N2) continues to evolve rapidly, frequently eroding population immunity and challenging seasonal vaccine strain selection. During the 2025/26 season, the A(H3N2) subclade K (J.2.4.1) expanded quickly across multiple regions and showed evidence of antigenic divergence in standard assays. <b>Methods:</b> In this study, we combined phylogenetic analyses of hemagglutinin (HA) and neuraminidase (NA) sequences with a systematic synthesis of recent peer-reviewed studies and official surveillance reports to comprehensively define the molecular profile and early epidemiological dynamics of subclade K. <b>Results:</b> Our phylogenetic reconstructions of HA and NA genes confirmed the emergence of a coherent and recently diversified lineage characterized by coordinated evolution of surface glycoproteins and broad geographic representation during 2025. Integration of molecular, temporal, and surveillance evidence further supported rapid expansion with limited early regional structuring. Antigenic analyses reported in peer-reviewed studies described reduced haemagglutination inhibition reactivity to vaccine reference antisera for many subclade K viruses, whereas vaccine effectiveness (VE) estimates from multiple settings remained moderate. <b>Conclusions:</b> Overall, the available genetic, antigenic, and epidemiological evidence indicates that subclade K represents a recently diversified A(H3N2) lineage associated with rapid international spread during the 2025/26 season, highlighting the importance of integrated HA/NA genomic surveillance and timely antigenic characterization to support evidence-based vaccine strain selection.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Outpatient Antibiotic Prescriptions Issued in Croatian Primary Healthcare, 2015-2024.","authors":"Anamaria Jurčević, Jelena Dimnjaković, Rok Čivljak","doi":"10.3390/idr18020036","DOIUrl":"10.3390/idr18020036","url":null,"abstract":"<p><strong>Objectives: </strong>Outpatient antibiotic prescribing is a major driver of antimicrobial resistance, yet detailed long-term analyses of prescribing patterns in Croatia remain limited. This study aimed to analyze trends in outpatient antibiotic prescriptions issued in Croatian primary healthcare from 2015 to 2024, stratified by antibiotic class, substance, and the WHO AWaRe classification.</p><p><strong>Methods: </strong>A retrospective analysis of nationwide data on antibiotic prescriptions issued in primary care outpatient settings was conducted using the data from the Central Health Information System of the Republic of Croatia. All prescriptions for ATC group J01 antibiotics issued between 1 January 2015 and 31 December 2024 were included. The primary outcome was the annual number of issued outpatient antibiotic prescriptions, described overall and by substance. Annual counts were additionally expressed as a percentage of the 2015 baseline (index year = 100%) to enable the comparison across substances with different prescribing volumes. The prescriptions were classified according to the WHO AWaRe framework.</p><p><strong>Results: </strong>A total of 31,048,414 outpatient antibiotic prescriptions were issued between 2015 and 2024. Overall prescribing declined by 5.6% from 2015 to 2019, followed by a marked decrease of 21.0% in 2020, and subsequently rebounded to 3,338,235 prescriptions by 2024, a number virtually identical to pre-pandemic levels. Co-amoxiclav and azithromycin together accounted for 49.5% of all prescriptions. By 2024, prescribing third-generation cephalosporins increased by 281.9% compared to the 2015 levels, while prescribing amoxicillin decreased by 43.6% over the same period. The proportion of Access antibiotics declined from 64.7% in 2015 to 57.9% in 2024.</p><p><strong>Conclusions: </strong>The main challenge for antimicrobial stewardship in Croatia lies not only in overall prescribing volume but in prescribing composition. Targeted interventions are needed to reduce reliance on broad-spectrum agents and promote the use of narrower-spectrum first-line alternatives.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of <i>Mycoplasma genitalium</i> and Co-Infections with <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> Among Japanese Women: A Cross-Sectional Study.","authors":"Hiroshige Mikamo, Yuka Yamagishi, Daisuke Sakanashi","doi":"10.3390/idr18020035","DOIUrl":"10.3390/idr18020035","url":null,"abstract":"<p><p><b>Background/Objectives</b>: <i>Mycoplasma genitalium</i> is an emerging cause of sexually transmitted infections (STIs) and is increasingly recognized for its association with cervicitis and pelvic inflammatory disease. However, prevalence data in specific Japanese subpopulations, particularly comparing pregnant and non-pregnant women, remains limited. This study aimed to determine the prevalence of <i>M. genitalium</i> and its co-infection rates with <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> among Japanese women. <b>Methods</b>: A cross-sectional study was conducted using vaginal swab specimens collected between April 2021 and November 2022 from patients visiting two clinics in Gifu, Japan. The study population comprised 2138 non-pregnant women presenting with urogenital symptoms or sexual contact history, and 236 pregnant women undergoing routine antenatal screening. Detection was performed using real-time polymerase chain reaction assays on the cobas^® 8800 system (Roche Diagnostics). <b>Results</b>: Among non-pregnant women, the overall prevalence was 3.8% (82/2138) for <i>M. genitalium</i>, 3.4% (72/2138) for <i>C. trachomatis</i>, and 0.4% (9/2138) for <i>N. gonorrhoeae</i>. Co-infection rates were low; <i>M. genitalium</i> and <i>C. trachomatis</i> co-infection was observed in 0.2% of cases. Among pregnant women, the prevalence was 3.8% (9/236) for both <i>M. genitalium</i> and <i>C. trachomatis</i>, and 0.4% (1/236) for <i>N. gonorrhoeae</i>. No statistically significant differences in prevalence were observed between pregnant and non-pregnant women for any pathogen. <b>Conclusions</b>: The prevalence of <i>M. genitalium</i> in this Japanese cohort was comparable to that of <i>C. trachomatis</i> in both pregnant and non-pregnant women, highlighting its significance as a major STI pathogen. These findings underscore the importance of including <i>M. genitalium</i> in routine STI screening panels for symptomatic women and antenatal care to prevent reproductive health complications. Given the high rates of antimicrobial resistance documented in Japanese <i>M. genitalium</i> strains, specific diagnostic testing is essential to enable targeted, resistance-guided therapy.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Newer Therapeutics to Selectively Kill <i>Clostridioides difficile</i> and Restore the Microbiome.","authors":"Guido Granata, Nicola Petrosillo","doi":"10.3390/idr18020034","DOIUrl":"10.3390/idr18020034","url":null,"abstract":"<p><strong>Background: </strong>The antibiotic ibezapolstat and the live biotherapeutic product live-JSLM are promising future approaches for treating <i>Clostridioides difficile</i> infection. Ibezapostat is a highly specific antibiotic for <i>Clostridioides difficile</i>, with minimal impact on the intestinal flora. Live-JSLM is designed to restore healthy intestinal microbiota, thus preventing recurrence of <i>Clostridioides difficile</i> infection. In this narrative review, we reviewed available data on ibezapostat and live-JSLM, considering that they are prototypes of two distinct, unique mechanisms of action against <i>Clostridioides difficile</i>.</p><p><strong>Methods: </strong>Data sources: PubMed and SCOPUS databases were searched from 1 January 2012 to 15 November 2025. Original articles reporting data on ibezapolstat and live-JSLM were included.</p><p><strong>Results: </strong>31 studies were included. When compared to conventional anti-<i>Clostridioides difficile</i> antibiotics, ibezapolstat had a similar level of effectiveness and minimal impact on the gut microbiota. The available data confirm live-JSLM safety and efficacy in restoring the gut microbiota following the conclusion of the standard anti-<i>Clostridioides difficile</i> antibiotic regimen.</p><p><strong>Conclusions: </strong>The results on ibezapolstat efficacy are promising, but require confirmation in larger patient populations through double-blind, randomised phase III trials. In the near future, an integrated approach may enhance the management of <i>Clostridioides difficile</i> infection: starting with highly specific antibiotics, i.e., ibezapolstat, followed by microbiome-based therapies such as live-JSLM.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive Multifocal Leukoencephalopathy in AIDS: The Diagnostic Role of PET Imaging.","authors":"Virginia Donini, Riccardo Paggi, Alberto Farese, Costanza Malcontenti, Enrico Tagliaferri, Claudio Caroselli, Spartaco Sani, Maria Matteini, Alessandro Bartoloni, Lorenzo Zammarchi","doi":"10.3390/idr18020033","DOIUrl":"10.3390/idr18020033","url":null,"abstract":"<p><strong>Introduction: </strong>The majority of progressive multifocal leukoencephalopathy (PML) cases is still represented by patients affected by acquired immunodeficiency syndrome (AIDS). Diagnosis of PML relies on histopathological findings or by the combination of clinical signs, radiological evidence, and molecular positivity of the JC virus in cerebrospinal fluid. However, AIDS status predisposes to various diseases involving the brain, testing the diagnostic ability of the clinician.</p><p><strong>Case description: </strong>We describe a PML case in a patient with AIDS, in whom lumbar puncture was initially impossible for severe thrombocytopenia and magnetic resonance showed an hyperintense lesion and was unable to distinguish between PML and lymphoma. In this case, [¹⁸F]-fluorodeoxyglucose (FDG)-PET imaging showing a hypometabolism of the lesion helped to initially orient toward PML, as diagnosis was later confirmed by lumbar puncture. We collected 21 cases in the literature in which [¹⁸F]-FDG-PET was helpful in cases of PML.</p><p><strong>Discussion and conclusions: </strong>PET imaging is not considered a standard diagnostic tool for PML. However, in selected cases, it may provide valuable information to direct the diagnosis towards PML.</p>","PeriodicalId":13579,"journal":{"name":"Infectious Disease Reports","volume":"18 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13116376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}