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Issue: Newsletter 3 | August 15, 2025

Randomised Controlled Trials

Citation of Articles PICO Main Results Risk of Bias
Turner NA, Hamasaki T, Doernberg SB, Lodise TP, King HA, Ghazaryan V, et al. Dalbavancin for Treatment of Staphylococcus aureus Bacteremia: The DOTS Randomized Clinical Trial. JAMA. 2025 Aug 13. doi: 10.1001/jama.2025.12543
- Editorial: McCreary EK, Malani PN. New Pathways to Treat Staphylococcus aureus Bacteremia: Connecting the DOTS. JAMA. 2025 Aug 13. doi: 10.1001/jama.2025.13717 		P: 200 adults with complicated S. aureus bacteremia
I: Dalbavancin (2 IV doses of 1500 mg, days 1 and 8)
C: Standard IV therapy (4–8 weeks)
O: DOOR at day 70; clinical efficacy/safety at day 70 		Dalbavancin was not superior to standard therapy for complicated S. aureus bacteremia; probability of a more desirable outcome at day 70 was 47.7% (95% CI, 39.8%–55.7%), below the superiority threshold. Clinical efficacy at day 70 was similar in both arms, supporting noninferiority (difference 1.0%, 95% CI −11.5% to 13.5%). Serious adverse events: 40% (dalbavancin) vs 34% (standard). Noninferior, comparable safety profile. Moderate risk: Randomization and assessor masking help reduce bias, but the open-label design could introduce performance bias. Exclusion criteria limit generalizability. Composite outcome includes subjective elements.
Heltveit-Olsen SR, Arnljots ES, Sundvall P-D, Gunnarsson R, Kowalczyk A, Godycki-Cwirko M, et al. Methenamine hippurate as prophylaxis for recurrent urinary tract infections in older women—a triple-blind, randomised, placebo-controlled, phase IV trial (ImpresU). Clin Microbiol Infect. 2025 Jul 14. doi:10.1016/j.cmi.2025.07.006 P: 289 older women (≥70 years) with recurrent UTIs
I: Methenamine hippurate 1g twice daily for 6 months
C: Placebo
O: Number of antibiotic-treated UTIs 		281 women were included. During treatment, methenamine hippurate reduced incidence of antibiotic-treated UTIs vs placebo (IRR 0.75, 95% CI 0.57–1.0, p=0.049). After stopping treatment, incidence was higher in methenamine group (IRR 1.7, 95% CI 1.3–2.3, p<0.001). No significant differences in severity/duration/complications. Low risk: Triple-blind, randomised, placebo-controlled; balanced arms; ITT and per-protocol analyses.
Randremanana RV, Raberahona M, Bourner J, Rajerison M, Edwards T, Randriamparany R, et al. Ciprofloxacin versus aminoglycoside–ciprofloxacin for bubonic plague. N Engl J Med. 2025 Aug 6;393:544–555. doi:10.1056/NEJMoa2413772
 - Editorial: Mead P. Chipping away at an old foe. N Engl J Med. 2025 Aug 6;393:603–604. doi:10.1056/NEJMe2507682 		P: 450 patients with suspected bubonic plague (222 confirmed/probable)
I: Oral ciprofloxacin 10 days
C: Injectable aminoglycoside 3 days + oral ciprofloxacin 7 days
O: Treatment failure by day 11; mortality/adverse events 		Among the 222 confirmed/probable, treatment failure occurred in 9.0% (ciprofloxacin) vs. 8.1% (aminoglycoside–ciprofloxacin), confirming noninferiority. Similar deaths, secondary pneumonic plague, and adverse event rates. Moderate risk: Open-label, randomized; robust endpoint, but unblinded design may introduce performance/detection bias.
McCreary EK, Davis JS, Tong SYC, Huttner A. Communicable Episode 26: SNAP out of it - rethinking anti-staphylococcal penicillins for S. aureus bacteraemia, the SNAP trial PSSA/MSSA results. CMI Commun. 2025 Aug 5. doi:10.1016/j.cmicom.2025.105121 P: Patients with PSSA and MSSA S. aureus bacteraemia
I: Penicillin (PSSA) or cefazolin (MSSA)
C: Flucloxacillin
O: Non-inferior efficacy and possibly improved safety 		Early results from the SNAP trial suggest that penicillin and cefazolin are non-inferior and may be safer than flucloxacillin for PSSA and MSSA bacteraemia. Moderate risk: Podcast format summarizes preliminary data; full peer-reviewed publication awaited for comprehensive risk assessment.
Klementová T, Zákoucká H, Bížová B, Unemo M, Rob F. Cefixime versus benzathine penicillin G for early syphilis—a randomized, controlled open label trial. J Antimicrob Chemother. 2025 Aug 7;dkaf268. doi:10.1093/jac/dkaf268 P: 61 patients with confirmed early syphilis
I: Cefixime 400 mg twice daily for 14 days
C: Single dose benzathine penicillin G
O: ≥4-fold decrease in VDRL at 3 and 12 months; safety 		58 completed the study; at 3 months, 73.3% (cefixime) vs. 87.1% (BPG) achieved endpoint; at 12 months, 93.3% (cefixime) vs. 96.8% (BPG). Both well-tolerated, no severe adverse events. Moderate risk: Open-label design may introduce bias; randomization and control group enhance internal validity.
Rutakingirwa MK, Skipper CP, Dai B, Wele A, Namombwe S, Mugabi T, et al. Evaluating lower dose flucytosine for cryptococcal meningitis: a clinical trial. Clin Infect Dis. 2025 Aug 7;ciaf432. doi:10.1093/cid/ciaf432 P: 48 adults with HIV and cryptococcal meningitis
I: Flucytosine 60 mg/kg/day for 10 days (w/ amphotericin B + fluconazole)
C: Historical controls: flucytosine 100 mg/kg/day
O: Early fungicidal activity, CSF sterility, survival, adverse events 		EFA with reduced dose was 0.28 log₁₀ CFU/mL/day vs. 0.41 in controls (P=0.019); 18-week survival 77%. Reduced dose was inferior in fungal clearance; similar toxicity rates. Moderate risk: Single-arm, open-label phase II; small sample size, historical controls limit comparability, but endpoints are robust.
Ong SWX, Pinto R, Rishu A, Tong SYC, Fowler RA, Daneman N, et al. Clinical course of patients with bloodstream infections enrolled in the BALANCE clinical trial. J Antimicrob Chemother. 2025 Aug 4. doi:10.1093/jac/dkaf294 P: 3608 hospitalized patients with bloodstream infection
I: 7 days of antibiotics
C: 14 days of antibiotics
O: Recovery trajectories, 90-day mortality 		Recovery trajectories nearly identical between 7- and 14-day groups. Survivors had faster recovery; antibiotic duration did not impact recovery patterns. Low risk: Large RCT with robust data, but post hoc descriptive; causality limited, subgroup comparisons observational.
Wagner AP, Enne V, Gant V, Stirling S, Barber JA, Livermore DM, et al. Cost-effectiveness of rapid, ICU-based PCR in HAP: INHALE WP3 RCT. Crit Care. 2025;29:352. doi:10.1186/s13054-025-05428-1 P: 531 ICU patients with hospital-acquired/ventilator-associated pneumonia
I: Rapid, PCR-guided therapy
C: Standard care
O: Antibiotic stewardship at 24 hours, clinical cure at 14 days, cost-effectiveness 		PCR-guided therapy improved antibiotic stewardship, reduced ICU costs, but lowered clinical cure rate at 14 days (56.7% vs 64.5%). Cost-effective for stewardship, not for clinical cure. Low-moderate risk: Pragmatic RCT design with robust economic evaluation, but variability in cure rates, site-level differences noted.
Plant BJ, Einarsson GG, Deasy KF, Dahly D, Singh PK, Barry PJ, et al. Cystic Fibrosis Microbiome-directed Antibiotic Therapy Trial (CFMATTERS). Eur Respir J. 2025;66(2):2402443. doi:10.1183/13993003.02443-2024 P: 149 adults with CF and chronic P. aeruginosa, hospitalised for exacerbation
I: IV antibiotics + additional microbiome-directed antibiotic
C: Usual IV antibiotics
O: Change in ppFEV1 at 14 days, secondary outcomes 		No significant difference in ppFEV1 at 14 days (−1.1%, 95% CI −3.9–1.7%; p=0.46), more IV days, more exacerbations, worse HRQoL in microbiome-directed group. Low-moderate risk: Pragmatic multicentre RCT, objective outcomes; possible lack of blinding, group size imbalance.
Luetkemeyer AF, Donnell D, Cohen SE, Dombrowski JC, Grabow C, Haser G, et al. Doxycycline to prevent bacterial STIs in the USA: DoxyPEP RCT. Lancet Infect Dis. 2025;25(8):873-883. doi:10.1016/S1473-3099(25)00085-4 P: 637 MSM and transgender women with ≥1 bacterial STI in past year
I: Doxycycline post-exposure prophylaxis (200 mg)
C: Standard care
O: Quarterly incidence of bacterial STIs 		STI detected in 12.0% of doxy-PEP quarters vs 30.5% in standard care (RR 0.39, 95% CI 0.31–0.49, p<0.0001); efficacy persisted in open-label extension. Some increase in tetracycline resistance. Low-moderate risk: Multicentre, open-label RCT with masked endpoint; limitations: open-label, site-level assignment, possible resistance emergence.
Sethi NJ, Carlsen ELM, Tabassum A, Cortes D, Markøw S, Schmidt IM, et al. Efficacy and safety of individualised vs standard antibiotic treatment in children with febrile UTI (INDI-UTI). Lancet Infect Dis. 2025;25(8):925-935. doi:10.1016/S1473-3099(25)00103-7 P: 408 children aged 3 months–12 years with febrile UTI
I: Individualised duration (min 4 days, stop 3 days after improvement)
C: Standard 10-day treatment
O: Recurrent UTI within 28 days; total antibiotic days 		Recurrent UTI in 11% (individualised) vs 6% (standard); difference 5.3pp, met non-inferiority. Median antibiotic days: 6 vs 10 (−4 days, p<0.0001). Fewer adverse events in individualised group. Low-moderate risk: Pragmatic, multicentre, open-label RCT; strengths: ITT analysis; limitations: open-label, potential reporting bias.
Opdam MAA, den Broeder N, van Crevel R, Schapink L, Raymakers L, Broen J, et al. Continuation vs temporary interruption of immunomodulatory agents during infections in patients with IRD: RCT. Clin Infect Dis. 2025;ciaf442. doi:10.1093/cid/ciaf442 P: 474 patients with IRD on immunomodulatory agents with infection
I: Continuation of immunomodulatory agents
C: Temporary interruption
O: Serious infection, secondary: CACE analysis for non-adherence 		Serious infections: 5.15% (interruption) vs 3.73% (continuation), adjusted risk difference 1.71% (95% CI –1.99 to 5.39). No significant differences; similar risk and outcomes. Low-moderate risk: Multicentre, open-label RCT. Strengths: intention-to-treat and CACE analyses. Limitations: open-label, low event rates, low statistical power.

Antibiotic Use

Howroyd F, Gill R, Thompson J, Duggal NA, Ahmed Z, Veenith T, et al. Ventilator-associated pneumonia: mechanisms, an appraisal of current therapies and the role for inhaled antibiotics in prevention and treatment. Respir Med. 2025 Oct;247:108275. doi: 10.1016/j.rmed.2025.108275

  • Summary: This review examines the complex mechanisms and challenges in preventing and treating ventilator-associated pneumonia (VAP), critically appraises current therapies, and discusses the potential and controversy surrounding the clinical use of inhaled antibiotics, which may offer targeted benefits and reduced systemic side effects but lack consistent evidence from large-scale trials for routine adoption.

Winner KM, Chanderraj R, Nuppnau M, He Y, Petouhoff AM, Falkowski NR, et al. Anti-anaerobic antibiotics, gut microbiota, and sepsis-associated acute kidney injury. Am J Respir Crit Care Med. 2025. doi: 10.1164/rccm.202411-2281OC

  • Summary: Through multiple complementary analyses in patients and mice, this study demonstrates that early administration of anti-anaerobic antibiotics in sepsis is associated with an increased risk of acute kidney injury, potentially due to disruption of gut microbiota—highlighting a possible link between antibiotic selection, gut microbial ecology, and renal outcomes in septic patients. There has been some controversy online about these results.

Fratoni AJ, Gethers ML, Nicolau DP, Kuti JL. Non-KPC attributes of the newer β-lactam/β-lactamase inhibitors, part 2: Burkholderia cepacia complex, Stenotrophomonas maltophilia, and Acinetobacter baumannii. Clin Infect Dis. 2025 Jul 21;ciaf403. doi:10.1093/cid/ciaf403

  • Summary: Focusing on non-KPC carbapenem-resistant organisms, this review highlights the activity and clinical utility of newer β-lactam/β-lactamase inhibitor combinations—including ceftazidime/avibactam, meropenem/vaborbactam, imipenem/relebactam, and sulbactam/durlobactam—against challenging Gram-negative pathogens such as Burkholderia cepacia complex, Stenotrophomonas maltophilia, and Acinetobacter baumannii.

Koenig C, Nicolau DP, Asempa TE. Sulbactam-durlobactam in combination with aztreonam and carbapenems against carbapenem-resistant Acinetobacter baumannii: an assessment using the MIC-based broth disk elution. J Clin Microbiol. 2025 Jul 24. doi:10.1128/jcm.00709-25

  • Summary: This letter evaluates the in vitro activity of sulbactam-durlobactam combined with aztreonam or carbapenems using the broth disk elution method against carbapenem-resistant Acinetobacter baumannii, finding that such combinations may help overcome resistance mechanisms involving metallo-β-lactamases, PBP3 mutations, and efflux, and could be considered as therapeutic options for multidrug-resistant ABC infections.

Wu T, Ding Q, Huang S, Zhang S, Yang R, Qin Y, et al. Model-informed individualized administration of ceftazidime–avibactam in critically ill patients: population pharmacokinetics studies and a parametric time-to-event analysis. J Antimicrob Chemother. 2025 Aug 7;dkaf275. doi:10.1093/jac/dkaf275

  • Summary: This study developed and validated a population pharmacokinetic model for ceftazidime–avibactam in critically ill Chinese adults, used time-to-event analysis to identify ceftazidime exposure and mechanical ventilation as key risk factors for acute kidney injury, and provided renal function-stratified dosing recommendations that optimize both efficacy and safety for individualized therapy.

Seki M. Optimizing antimicrobial use in Japan: strategies for dosage, combination therapy, de-escalation, oral switching, duration, and guideline adherence. Clin Pharm Adv. 2025;17:227-33. doi:10.2147/CPAA.S539674

  • Summary: This article reviews antimicrobial stewardship practices in Japan, highlighting strategies such as individualized dosing, empiric combination therapy for severe and drug-resistant infections, timely initiation and de-escalation of antibiotics, careful implementation of intravenous-to-oral switching, and duration decisions based on disease pathophysiology and guideline adherence—demonstrating how these approaches have advanced antimicrobial optimization in Japanese clinical practice.

Kanjee Z, Stead W, Jassar A, Reynolds EE. How would you treat tricuspid valve infective endocarditis in a patient who uses injection drugs? Grand Rounds discussion from Beth Israel Deaconess Medical Center. Ann Intern Med. 2025 Aug 12;25:02049. doi:10.7326/ANNALS-25-02049

  • Summary: This article presents a grand rounds discussion between an infectious diseases specialist and a cardiac surgeon, addressing medical and interventional management strategies, multidisciplinary care, and guideline-based recommendations for the complex treatment of tricuspid valve infective endocarditis in people who inject drugs, exemplified by the case of a 30-year-old man with substance use disorder and right-sided endocarditis due to methicillin-sensitive Staphylococcus aureus.

Warecki BA, Tamma PD, Bonomo RA, Vila AJ. NDM-driven cefiderocol resistance: effect and therapeutic considerations. Lancet Infect Dis. 2025 Aug 11. doi:10.1016/S1473-3099(25)00477-3

  • Summary: This article reviews the rising global threat of antimicrobial resistance posed by metallo-β-lactamase (MBL)–producing pathogens, particularly the New Delhi MBL (NDM) variants, and discusses ongoing efforts to counteract NDM-driven cefiderocol resistance through the development of novel MBL inhibitors and β-lactam antibiotics with improved resistance to enzymatic degradation.

Liu C, Rosen EA, Stohs EJ, Imlay H, Nigo M, Gottesdiener LS, et al. Tackling antimicrobial resistance in people who are immunocompromised: leveraging diagnostic and antimicrobial stewardship. Lancet Infect Dis. 2025 Aug 11. doi:10.1016/S1473-3099(25)00311-1

  • Summary: This article reviews how antimicrobial resistance disproportionately threatens immunocompromised patients by restricting treatment options and highlights the critical roles of diagnostic and antimicrobial stewardship, including emerging and existing diagnostic tools, digital innovations, and precision medicine approaches, to optimise antibiotic use and improve outcomes in this vulnerable population.

Phage Therapy

Jones JD, Stacey HJ, Suleman M, Langley RJ. The importance of patient information and informed consent for unlicensed phage therapy. Clin Microbiol Infect. 2025 Aug 6. doi:10.1016/j.cmi.2025.07.032

  • Summary: This commentary highlights that as unlicensed phage therapy is increasingly used to address antimicrobial resistance, ensuring patients receive comprehensive information and give informed consent is critical, given the lack of regulatory evaluation for the quality, safety, and efficacy of these treatments.

Meta-analyses

Arbiv OA, Holmes T, Kim MJ, Yan M, Romanowski K, Brode SK, et al. Safety of triple-dose rifampin in tuberculosis treatment: a systematic review and meta-analysis. Clin Infect Dis. 2025 Jul 15;81(1):119-128. doi: 10.1093/cid/ciaf004

  • Summary: This systematic review and meta-analysis of randomized trials found that triple-dose rifampin regimens for tuberculosis, compared to standard dosing, are associated with a higher rate of severe adverse events—particularly liver toxicity—without a difference in mortality, raising safety concerns about the use of high-dose rifampin.

Liu M, Gao Y, Zheng L, Li Z, Yao L, Xu J, et al. Shorter versus longer-duration antibiotic treatments for immunocompetent patients with bloodstream infections: a systematic review and meta-analysis. EClinicalMedicine. 2025 Aug;86:103397. doi: 10.1016/j.eclinm.2025.103397

  • Summary: This systematic review and meta-analysis of 11 randomized controlled trials finds that shorter-duration antibiotic therapy for immunocompetent patients with bloodstream infections is as effective as longer courses in terms of mortality, treatment failure, and relapse, while also reducing hospital stay, though subgroup and adverse event data remain limited and warrant cautious interpretation.

Espinosa-Pereiro J, Aguiar A, Nara E, Medina A, Molinas G, Tavares M, et al. Safety, efficacy, and pharmacokinetics of daily optimized doses of rifampicin for the treatment of tuberculosis: a systematic review and Bayesian network meta-analysis. Clin Infect Dis. 2025 Jul 15;81(1):129-142. doi: 10.1093/cid/ciaf003

  • Summary: This systematic review and Bayesian network meta-analysis found that higher daily doses of rifampicin (especially 40 mg/kg/day) increase the risk of overall and hepatic adverse events but can improve sputum culture conversion in tuberculosis, suggesting that optimal dosing may lie between 25 and 35 mg/kg/day and should be tailored to individual or population needs.
  • Editorial Commentary:
    Maranchick NF, Peloquin CA. High time for higher-dose rifampin. Clin Infect Dis. 2025 Jul 15;81(1):143-144. doi: 10.1093/cid/ciaf005
    • Summary: This editorial comments on emerging research supporting the use of higher-than-standard doses of rifampin for tuberculosis, arguing that the historical rationale for the current 600 mg dose no longer applies given improved supply and affordability, and calling for reconsideration of optimal rifampin dosing in modern TB treatment.

Bacterial Infections

Murthy S, Hagedoorn NN, Faigan S, Rathan MD, Sharples KJ, Marchello CS, et al. Global typhoid fever incidence: an updated systematic review with meta-analysis. Lancet Infect Dis. 2025 Jul 31. doi:10.1016/S1473-3099(25)00359-7

  • Summary: This updated systematic review and meta-analysis found typhoid fever incidence remains highest in Africa and Asia, particularly among young children, reinforcing the need for targeted vaccine and non-vaccine prevention strategies in these regions.

Bonnin RA, Jousset AB, Jacquemin A, Emeraud C, Girlich D, Naas T, et al. Genetic diversity, biochemical properties, epidemiology, and detection methods of IMP- and VIM-type carbapenemases. Antimicrob Chemother. 2025 Aug 1. doi:10.1128/cmr.00129-23

  • Summary: This review discusses the genetic diversity, epidemiology, biochemical properties, and detection challenges of IMP- and VIM-type carbapenemases in Gram-negative bacteria, highlighting their increasing prevalence, diagnostic limitations, and the performance of current detection methods and inhibitors.

Li J, Cheng G, Qin X, Liu J. Streptococcus pneumoniae β-lactam resistance: epidemiological trends, molecular drivers, and innovative control strategies in the post-pandemic era. Clin Microbiol. 2025 Jul 31. doi:10.1128/cmr.00082-25

  • Summary: This review synthesizes advances in the epidemiology, molecular mechanisms, and management of β-lactam resistance in Streptococcus pneumoniae, noting the impact of vaccines, regional disparities, and the evolving role of novel therapies and artificial intelligence in addressing resistance trends, especially in the post-pandemic era.

Barcellini L, Sterzi L, Comandatore F, Panelli S, Forlanini F, Crivellaro E, et al. Enterobacterales gut colonization and late-onset sepsis in neonates: a multicenter prospective study across 18 neonatal intensive care units in six countries. Clin Microbiol Infect. 2025 Aug 2. doi:10.1016/j.cmi.2025.07.025

  • Summary: This multicenter prospective study across six countries revealed that gut-derived Enterobacterales are major contributors to late-onset sepsis in neonates, with whole-genome sequencing confirming frequent gut-to-blood translocation, especially in extremely preterm and low-birth-weight infants, highlighting opportunities for targeted prevention strategies.

Kouijzer IJE, Hernández-Meneses M, Aarntzen EHJG, Ahl J, Baddour LM, DeSimone DC, et al. Treatment and follow-up of vascular graft and endograft infection: Delphi consensus document. Clin Microbiol Infect. 2025 Jul 29. doi:10.1016/j.cmi.2025.07.020

  • Summary: This Delphi consensus document provides comprehensive expert recommendations for multidisciplinary management and follow-up of vascular graft and endograft infection, emphasizing individualized antimicrobial strategies and standardized approaches for complex cases where high-level evidence is often lacking.

Cassir N, Ghani R, Biehl LM, Graells T, Kuijper EJ, Mullish BH, et al. Non-antimicrobial therapies for recurrent urinary tract infection in women: is there a place for faecal microbiota transfer? Clin Microbiol Infect. 2025 Jul 29. doi:10.1016/j.cmi.2025.07.022

  • Summary: This narrative review summarizes evidence on faecal microbiota transfer as a promising non-antimicrobial intervention for recurrent urinary tract infection in women, discussing its potential, current limitations, and the need for randomized trials to establish efficacy and optimize procedures.

Monardo R, Park LP, Ruffin F, Cox P, Dinh AQ, Korn RE, et al. Clinical and genomic characterization of Serratia bloodstream infections. CMI Commun. 2025 Aug 6. doi:10.1016/j.cmicom.2025.105128

  • Summary: This prospective cohort and genomic study found that Serratia bacteremia, once rare, is now an emerging infection associated with increased risk of device-related and cardiac device infections and persistent bacteremia compared to other Enterobacterales, with whole genome sequencing showing substantial genetic diversity among isolates and no clonal basis for device infection, highlighting the need for further research into its pathogenic mechanisms.

Lee IR, Zhu Y, Rai NJ, O’Sullivan M, Dotel R, Robinson JO, et al. Adherence to quality-of-care indicators and mortality outcomes in patients with MRSA bacteremia: a post hoc analysis of the CAMERA2 randomized clinical trial. JAMA Netw Open. 2025;8(7):e2523220. doi:10.1001/jamanetworkopen.2025.23220

  • Summary: This post hoc analysis of the CAMERA2 trial shows that health care practitioners managing trial participants with MRSA bacteremia adhered better to quality-of-care indicators than those treating nontrial patients, but this improved adherence did not translate into lower 90-day mortality rates.

Jiang J, Wang L, Hu Y, Chen X, Li P, Zhang J, et al. Global emergence of carbapenem-resistant hypervirulent Klebsiella pneumoniae driven by an IncFIIK34 KPC-2 plasmid. EBioMedicine. 2025 Mar 1. doi:10.1016/j.ebiom.2025.105627

  • Summary: This study identifies the IncFIIK34 KPC-2 plasmid as a key driver of the global emergence and dissemination of carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKp), demonstrating that this plasmid confers high conjugation efficiency and resistance, while maintaining hypervirulence, and highlights the urgent need for enhanced molecular surveillance to address this rapidly spreading public health threat.

Felton EA, Jobson ME, Torres NJ, Washburn RM, Virgillio AM, Alvior J, et al. Emergence of ST3390: a novel apigmented MRSA clone from the CC5 lineage. J Infect Dis. 2025 Aug 7. doi:10.1093/infdis/jiaf410

  • Summary: This study identifies and characterizes ST3390, a rare and novel apigmented MRSA clone within the CC5 lineage, revealing its unique genomic features, lack of staphyloxanthin pigment, hybrid SCCmec elements, and enhanced cytotoxicity and virulence in experimental models, and highlighting both its emergence in Tampa and its broader implications for the diversification and pathogenic potential of hospital-associated MRSA.

Bouiller K, Cella E, Jacko NF, Hiehle ME, Azarian T, David MZ. Comparing clinical, microbiological and genetic definitions of relapse in patients with subsequent episodes of MRSA bone and joint infection. Clin Infect Dis. 2025 Aug 11. doi:10.1093/cid/ciaf448

  • Summary: This study found that among patients with recurrent MRSA bone and joint infections, clinical and microbiological criteria poorly distinguished relapse from new infection when compared to genomic definitions based on whole-genome sequencing, with the highest accuracy achieved using multilocus sequence typing, highlighting the limitations of conventional approaches in differentiating infection recurrence.

Brennan B, McNamara S, McCullor K, Soehnlen M, Campbell D, Gargis AS, et al. Investigation and laboratory characterization of the fifteenth U.S. case of vancomycin-resistant Staphylococcus aureus – Michigan, 2021. Infect Control Hosp Epidemiol. 2025 Aug 11;1-2. doi:10.1017/ice.2025.10225

  • Summary: The fifteenth U.S. case of vancomycin-resistant Staphylococcus aureus (VRSA), identified in an elderly Michigan nursing facility resident with chronic wounds and multiple comorbidities, was characterized by high-level vancomycin resistance due to acquisition of the vanA operon, responded to meropenem and daptomycin therapy, showed no evidence of onward transmission among 144 screened healthcare contacts, and whole genome sequencing suggested de novo acquisition of resistance from vancomycin-resistant Enterococcus rather than clonal spread, underscoring the importance of surveillance, rapid laboratory detection, and infection prevention in at-risk populations and settings.

Mycobacterial Infections

Cheli S, Torre A, Schiuma M, Montrasio C, Civati A, Galimberti M, et al. NAT2 slow acetylator phenotype as a significant risk factor for hepatotoxicity caused by antituberculosis drugs: results from a multiethnic nested case-control study. Clin Infect Dis. 2025 Jul 15;81(1):145–152. doi:10.1093/cid/ciae583

  • Summary: This multiethnic nested case-control study identifies NAT2 slow acetylator genotype as the strongest independent predictor of antituberculosis drug-induced liver injury, suggesting genotype-guided dosing may help optimize therapy and prevent hepatotoxicity

Khan U, Rich M, Franke MF, Lachenal N, Ahmed S, Bekele A, et al. The frequency and incidence of QT prolongation with extended use of bedaquiline or delamanid in a large, multi-country multidrug-resistant/rifampicin-resistant tuberculosis cohort. Clin Infect Dis. 2025 Jul 15;81(1):153–158. doi:10.1093/cid/ciae601

  • Summary: This prospective multicountry cohort study finds that extended use of bedaquiline and/or delamanid for multidrug-resistant tuberculosis is generally safe, with most clinically relevant QT prolongation events occurring within the first six months and only rare permanent discontinuations due to adverse events.

Tzelios CA, Malatesta S, Carney T, White LF, Weber SE, Thomson S, et al. Patient determinants and effects on adherence of adverse drug reactions to tuberculosis treatment: a prospective cohort analysis. Clin Infect Dis. 2025 Jul 15;81(1):167–175. doi:10.1093/cid/ciae642

  • Summary: In this South African cohort, half of tuberculosis patients on treatment experienced adverse drug reactions, with poorer adherence seen among those with moderate/severe ADRs, advanced HIV, alcohol use, or substance use, underscoring the importance of targeted adherence support.

Auma E, Alberts R, Derendinger B, Venter R, Streicher EM, Pillay S, et al. Diagnostic accuracy of LiquidArray MTB-XDR VER 1.0 for the detection of Mycobacterium tuberculosis complex, fluoroquinolone, amikacin, ethambutol, and linezolid susceptibility. Clin Infect Dis. 2025 Jul 15;81(1):159–166. doi:10.1093/cid/ciae614

  • Summary: This study validates the LiquidArray MTB-XDR VER 1.0 as a high-throughput test for detecting Mycobacterium tuberculosis complex and drug resistance, showing high sensitivity for fluoroquinolones and ethambutol, moderate sensitivity for amikacin and promise for linezolid, but indicating a need for improved detection to minimize missed resistance cases.

Yan M, Hernandez A, Chan KK, Stanbrook MB, Blanchette PS, Johnston JC, et al. Population-based analysis of the risk of mycobacterial infections associated with immune checkpoint inhibitors. Clin Infect Dis. 2025 Jul 15;81(1):176–178. doi:10.1093/cid/ciae626

  • Summary: This population-based nested case-control study found no significant association between immune checkpoint inhibitor use and increased risk of nontuberculous mycobacterial disease among cancer patients.

Ghebrekristos Y, Auma E, Mahlobo Z, Venter R, Beylis N, Achar J, et al. Waste to worth: diagnostic accuracy of Xpert MTB/XDR on contaminated liquid cultures to salvage the detection of drug-resistant tuberculosis. J Clin Microbiol. 2025 Jul 1. doi:10.1128/jcm.00580-25

  • Summary: This study demonstrates that applying Xpert MTB/XDR to contaminated Mycobacterium Growth Indicator Tube (MGIT) cultures destined to be discarded yields highly accurate drug susceptibility results for tuberculosis, improves diagnostic yield and timeliness for drug-resistant TB, and helps close care cascade gaps by providing crucial resistance data for patients who would otherwise be lost to follow-up due to culture contamination.

Solans BP, Miyakawa R, Shin M, Hesseling AC, White Y, Masini T, et al. Deriving dosages for levofloxacin tuberculosis preventive treatment for young people exposed to rifampicin-resistant tuberculosis. J Infect Dis. 2025 Aug 6;jiaf401. doi:10.1093/infdis/jiaf401

  • Summary: This study used pharmacokinetic modeling and simulations to establish weight-band dosing strategies for levofloxacin as tuberculosis preventive treatment in children and adolescents exposed to rifampicin-resistant TB, demonstrating that dosage regimens for both dispersible and solid tablet formulations achieve adequate drug exposures and have been adopted in updated WHO guidelines to facilitate simplified and effective preventive therapy for young people at risk.

Donohue S, Leisching G, Keane J. The emerging role of immunothrombosis in the control and pathogenesis of Mycobacterium tuberculosis. J Infect Dis. 2025 Aug 5;jiaf415. doi:10.1093/infdis/jiaf415

  • Summary: This article reviews evidence that immunothrombosis—a process involving macrophages, neutrophils, and platelets leading to microthrombus formation—plays a dual role in tuberculosis by both helping to contain Mycobacterium tuberculosis and contributing to disease pathogenesis, tissue damage, and drug resistance when dysregulated, suggesting that targeted modulation of this response could offer novel therapeutic strategies.

Churchyard GJ, Swindells S, Gupta A, Shah NS, Hughes M, Kim S, et al. Preventing multidrug resistant tuberculosis: the dawn of a new era. Clin Infect Dis. 2025 Aug 7;ciaf426. doi:10.1093/cid/ciaf426

  • Summary: This article reviews recent randomized trial evidence demonstrating that a six-month course of daily levofloxacin is safe and effective for preventing tuberculosis in household contacts exposed to multidrug-resistant TB, an advance that has led to updated WHO guidelines and marks the beginning of a new era in MDR-TB prevention, with novel shorter regimens in development promising further progress.

Fungal Infections

Choudhury S, Majhi K, Jena P, et al. Candida auris infections in ICU patients: risk factors, outcomes, and antifungal resistance patterns. Crit Care. 2025;29:332. doi: 10.1186/s13054-025-05544-y

  • Summary: This four-year retrospective study in an Indian ICU highlights the growing burden of multidrug-resistant Candida auris candidemia, with advancing age and female sex as independent risk factors, extensive antifungal resistance, and comparable mortality to non-auris Candida infections.

Meletiadis J, Guinea J, Arikan-Akdagli S, Meijer EFJ, Meis JF, Arendrup MC. A multicentre study for determination of epidemiological cut-off values for Candida auris with EUCAST broth microdilution reference methodology. J Antimicrob Chemother. 2025 Jul 29;dkaf241. doi:10.1093/jac/dkaf241

  • Summary: This multicentre study established EUCAST epidemiological cut-off values for several antifungal agents against Candida auris, enabling better identification of non-wild-type isolates and facilitating future clinical breakpoint development once outcome data are available.

Faure E, Cordier C, Delacoste H, Jeanne M, Dépret F, Hamane S, et al. Weekly screening of circulating Mucorales DNA and early treatment in severely burned patients improves survival: real-life bi-center experience in France. Clin Infect Dis. 2025 Jul 31;ciaf423. doi:10.1093/cid/ciaf423

  • Summary: This bi-center retrospective study in France found that systematic weekly screening for circulating Mucorales DNA in severely burned patients enabled earlier diagnosis and treatment of invasive wound mucormycosis, significantly reducing 100-day mortality in those with extensive burns.

Lass-Flörl C. Beyond guidelines: what do I need to know when dealing with fungal diagnostics? Clin Microbiol Infect. 2025 Jul 26. doi:10.1016/j.cmi.2025.07.016

  • Summary: This review offers practical guidance beyond current guidelines for diagnosing invasive fungal infections, emphasizing a multimodal, context-driven approach that considers host factors, specimen quality, and test limitations to improve diagnostic accuracy and patient outcomes.

Kramer KH, Marino CC, Driscoll E, Cheng S, Phillips K, Volpe PJ, et al. Medical cannabis as the source of Cryptococcus neoformans infection. Clin Infect Dis. 2025 Aug 4. doi:10.1093/cid/ciaf431

  • Summary: Using whole genome sequencing, this report definitively links a case of Cryptococcus neoformans infection in a patient with refractory multiple myeloma to contaminated medical cannabis, marking the first such proven transmission route.

Gatti M, Cojutti PG, Pea F. Role of a TDM-guided strategy of isavuconazole for optimizing efficacy/safety outcomes in onco-hematological pediatric patients: a systematic review. Chemotherapy. 2025 Aug 5. doi:10.1159/000547799

  • Summary: This systematic review of eight studies suggests that a therapeutic drug monitoring (TDM)-guided strategy for isavuconazole may help optimize drug exposure and improve efficacy and safety for onco-hematological pediatric patients with invasive fungal infections, as a notable proportion of patients do not reach optimal exposure with standard dosing and both underexposure and overexposure are associated with suboptimal outcomes, including increased risk of mortality and hepatotoxicity.

Erdem H, Şakir-Yildirim S, Ankarali H, Batirel A, Kul G, Fidan G, et al. Managing Candida auris fungemias: the results of a prospective and international study. Antimicrob Agents Chemother. 2025 Jun 25. doi:10.1128/aac.00358-25

  • Summary: This large prospective international study of 162 patients with Candida auris candidemia across 34 centers found a high 30-day mortality rate (56.2%), with key risk factors including inadequate access to antifungals, central venous catheters, ICU stay, abdominal surgery, deep-seated candidal complications, and thrombocytopenia, emphasizing the importance of early diagnosis, prompt echinocandin therapy, source control, and vigilant management of complications to optimize outcomes.

Bartalucci C, Vena A, Giacobbe DR, Bassetti M. Clinical impact of fluconazole-resistant Candida parapsilosis: a narrative review. Expert Rev Anti Infect Ther. 2025 Aug 11. doi:10.1080/17460913.2025.2544443

  • Summary: This narrative review highlights the global rise of fluconazole-resistant Candida parapsilosis, driven mainly by ERG11 gene mutations such as Y132F, describes the resulting hospital outbreaks and the controversy over the clinical impact on patient mortality, discusses the limited therapeutic options and challenges posed by echinocandin resistance and liposomal amphotericin B toxicity, and emphasizes the urgent need for antifungal stewardship and new therapeutic agents—such as rezafungin, fosmanogepix, and ibrexafungerp—to address this emerging threat.

Diagnostics

Conway Morris A, Nobre V, Coelho L, et al. Syndromic diagnostics in pneumonia: the quest for impact continues. Intensive Care Med. 2025. doi: 10.1007/s00134-025-08056-z

  • Summary: This article reviews evidence from recent trials on syndromic molecular diagnostics in pneumonia, highlighting that while rapid pathogen detection can support antimicrobial stewardship, its real-world impact depends on clinician adherence to protocols and integration with stewardship interventions, without clear improvement in patient outcomes.

Bain W, Sarma A, Morales-Nebreda L, Rizzo AN, Herron M, Wright SW, et al. Research priorities for noninvasive sampling of the lower respiratory tract during acute respiratory failure: an official American Thoracic Society workshop report. Ann Am Thorac Soc. 2025 Aug;22(8). doi: 10.1513/AnnalsATS.202505-543ST

  • Summary: This American Thoracic Society workshop report outlines current methods and future research priorities for noninvasive lower respiratory tract sampling in acute respiratory failure, emphasizing the need for standardized approaches and rigorous comparisons to optimize both research and clinical care.

Abegaz FA, Al-mir H, Kostyanev T, Prifti K, Kwon SY, Guarnacci T, et al. Strengthening antimicrobial resistance diagnostics in National Reference Laboratories across One Health in South and Southeast Asia: impact of external quality assessment and targeted follow-up. J Antimicrob Chemother. 2025 Jul 29;dkaf266. doi:10.1093/jac/dkaf266

  • Summary: This study demonstrates that external quality assessment combined with targeted follow-up and training significantly improves antimicrobial resistance diagnostic capacity and quality management practices in National Reference Laboratories across South and Southeast Asia.

Schuetz AN, Ferrell A, Hindler JA, Humphries R, Bobenchik AM. Overview of changes in the Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing: M100 32nd and 33rd editions. J Clin Microbiol. 2025 Aug 7. doi:10.1128/jcm.01623-23

  • Summary: This minireview summarizes major updates in the 32nd and 33rd editions of the Clinical and Laboratory Standards Institute M100 Performance Standards for Antimicrobial Susceptibility Testing, detailing new and revised breakpoints for various organisms, revised guidance for antimicrobial agent testing and reporting (including for multidrug-resistant gram-negative bacilli), as well as changes to quality control procedures and direct blood disk diffusion protocols, with supporting data and discussion of ongoing issues in the field.

Rhoads DD, Hanson ND, Reedy K, Gafsi J, Ying YX, Hardy DJ. First description of the performance of the VITEK MITUBE device used with MALDI-TOF mass spectrometry to achieve identification of gram-negative bacteria directly from positive blood culture broth. J Clin Microbiol. 2025 Jul 18. doi:10.1128/jcm.00122-25

  • Summary: This multicenter study demonstrates that the VITEK MITUBE device, when used with MALDI-TOF mass spectrometry, enables rapid and accurate identification of gram-negative bacteria directly from positive blood culture broths without subculture, achieving correct species identification in over 95% of clinical and contrived samples, and fulfilling a crucial need for quick, reliable, and cost-effective diagnostics in clinical microbiology.

Vereecke N, Yoon TB, Luo TL, Corey BW, Lebreton F, Mc Gann PT, et al. An open-source nanopore-only sequencing workflow for analysis of clonal outbreaks delivers short-read level accuracy. J Clin Microbiol. 2025 Jul 18. doi:10.1128/jcm.00664-25

  • Summary: This study introduces an optimized, open-source workflow for nanopore-only sequencing that achieves short-read level accuracy in clonal outbreak analysis, demonstrating highly concordant results with standard Illumina sequencing for core genome multilocus sequence typing and whole-genome comparisons across several clinical bacterial species, and providing a rapid, reliable tool for hospital infection control and epidemiologic investigations.

Fabre V, Hsu YJ, Carroll KC, Milstone AM, Salinas AB, Abbo LM, et al. Multicenter evaluation of blood culture contamination and blood culture practices in US acute care hospitals: time for standardization. J Clin Microbiol. 2025 Jul 11. doi:10.1128/jcm.00530-25

  • Summary: This multicenter study of over 360,000 blood cultures from 52 US hospitals revealed significant variability in definitions, monitoring, and practices for blood culture contamination, with lower contamination rates linked to standardized definitions, quality indicator monitoring, and limiting central catheter-drawn cultures, prompting a call for greater standardization to optimize blood culture stewardship and reduce associated adverse outcomes.

Improving Clinical Trials

Hassoun-Kheir N, Roncal Redin M, Labi AK, Loftus M, Stewardson AJ, Harbarth S, et al. Nomenclature, definitions, and methodological approaches to estimate the association between antimicrobial treatment and clinical outcomes of drug-resistant bloodstream infections: a systematic review. Clin Microbiol Infect. 2025 Aug 6. doi:10.1016/j.cmi.2025.07.033

  • Summary: This systematic review reveals substantial heterogeneity and high risk of bias in studies assessing the impact of inappropriate initial antibiotic treatment for drug-resistant bloodstream infections, underscoring the urgent need for harmonized definitions and improved research methodologies.

Seitz KP, Casey JD, Semler MW. Patient, treatment, outcome—large simple trials of common therapies. JAMA. 2025;334(5):395-7. doi:10.1001/jama.2025.9657

  • Summary: This editorial highlights the need for large, simple randomized trials of common therapies in critical care—using oxygen therapy as an example—to generate practical evidence that can directly inform everyday clinical decisions.

Chan AW, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, et al. SPIRIT 2025 statement: updated guideline for protocols of randomized trials. JAMA. 2025;334(5):435-43. doi:10.1001/jama.2025.4486

  • Summary: This Special Communication introduces the updated Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2025 statement, which includes substantive and structural changes to incorporate new evidence and emerging perspectives.

Taylor RS, Manyara AM, Ross JS, Ciani O. Surrogate end points in trials—SPIRIT and CONSORT extensions. JAMA. 2024;332(16):1340-2. doi:10.1001/jama.2024.15219

  • Summary: This editorial discusses the use of surrogate endpoints in clinical trials and recent updates to SPIRIT and CONSORT guidelines to improve their design and reporting.

Powers JH 3rd, O’Connell RJ. Developing, analyzing, and interpreting outcome assessments to improve endpoints in infectious diseases clinical research. Clin Infect Dis. 2025 Aug 15;81(Suppl 1):S4-10. doi:10.1093/cid/ciaf319

  • Summary: This article discusses strategies for developing, analyzing, and interpreting outcome assessments in infectious diseases clinical research, emphasizing the importance of patient-reported outcome measures that capture symptoms, function, and health-related quality of life, and outlines the processes for selecting relevant concepts, ensuring measurement validity, and appropriately analyzing and interpreting results to improve research endpoints and patient care.

Howard-Anderson J, Doernberg SB, Dixon D, Gopinath R, Rubin D, Kinamon T, et al. Interagency collaboration for patient-centered antibacterial drug development. Clin Infect Dis. 2025 Aug 15;81(Suppl 1):S11-5. doi:10.1093/cid/ciaf298

  • Summary: This article highlights the collaborative efforts of the Antibacterial Resistance Leadership Group and key U.S. agencies to develop and refine patient-centered endpoints, including health-related quality-of-life measures, for registrational antibacterial drug trials—ensuring that research priorities reflect patient experiences, needs, and outcomes.

Minter DJ, Wang TW, Rader A, Barton KD, Skalla LA, Boucher HW, et al. A systematic review of health-related quality-of-life measurement in patients with complicated urinary tract infections. Clin Infect Dis. 2025 Aug 15;81(Suppl 1):S16-23. doi:10.1093/cid/ciaf293

  • Summary: This systematic review identifies and evaluates measurement tools for health-related quality of life (HRQoL) studied in complicated urinary tract infection patients, revealing a limited but high-quality literature with diverse instruments and highlighting the need for standardization, development, and validation of HRQoL measures that capture patients' experiences for use as trial endpoints.

Sutton KN, Lydon E, Rader A, Barton KD, Skalla LA, Wang TW, et al. A systematic review of health-related quality-of-life measurement in patients with acute bacterial skin and skin structure infections. Clin Infect Dis. 2025 Aug 15;81(Suppl 1):S24-31. doi:10.1093/cid/ciaf294

  • Summary: This systematic review of health-related quality-of-life (HRQoL) measurement in acute bacterial skin and skin structure infections (ABSSSIs) found that while a wide range of generic and condition-specific instruments have been used, none fully capture the patient experience, with pain and impaired physical functioning being the most commonly affected domains; the findings underscore the need for the development and validation of targeted HRQoL tools for this patient group.

Krah NM, Fai C, Sutton KN, Rader A, Barton KD, Skalla LA, et al. A systematic review of health-related quality-of-life measurement in patients with hospital-acquired/ventilator-associated bacterial pneumonia. Clin Infect Dis. 2025 Aug 15;81(Suppl 1):S32-9. doi:10.1093/cid/ciaf296

  • Summary: This systematic review found that while existing studies consistently show hospital-acquired and ventilator-associated bacterial pneumonia negatively affects multiple domains of health-related quality of life (HRQoL), there is a lack of standardization and limited research on HRQoL measurement in this patient population, highlighting the need for more robust and uniform assessment tools in future studies.

Rader A, Ruffin F, Fai C, Barton KD, Skalla LA, Wang TW, et al. A systematic review of health-related quality-of-life measurement in patients with complicated intraabdominal infections. Clin Infect Dis. 2025 Aug 15;81(Suppl 1):S40-7. doi:10.1093/cid/ciaf299

  • Summary: This systematic review identified a wide range of health-related quality-of-life (HRQoL) measures used in studies of complicated intraabdominal infections (cIAIs), finding that while HRQoL generally improves after treatment, symptoms such as pain and fatigue are common and only the diverticulitis quality-of-life instrument has been psychometrically validated in this population, underscoring the need for rigorously tested, disease-specific HRQoL tools for cIAIs.

Ruffin F, Sutton KN, Miller J, Lane H, Schexnayder J, Oakes M, et al. A qualitative secondary analysis of patient health-related quality of life in bloodstream infections by source: intra-abdominal, urinary tract, and acute bacterial skin and skin structure infection. Clin Infect Dis. 2025 Aug 15;81(Suppl 1):S48-54. doi:10.1093/cid/ciaf295

  • Summary: This qualitative secondary analysis of interview data from patients with bloodstream infections originating from intra-abdominal, urinary tract, or skin/skin structure sources identified six key factors—ranging from preinfection health to fear of recurrence and social support—that shape the impact of these infections on health-related quality of life, illustrating the importance of developing HRQoL measures that reflect patient experiences across different infection types.

Robertson DS, Burnett T, Choodari-Oskooei B, Dimairo M, Grayling M, Pallmann P, et al. Confidence intervals for adaptive trial designs I: a methodological review. Stat Med. 2025 Aug 8. doi:10.1002/sim.70174

  • Summary: This methodological review—first in a two-part series—examines the challenges of constructing confidence intervals (CIs) for adaptive clinical trial designs, reviews a range of statistical methods for producing valid CIs that account for trial adaptations, and systematically assesses these methods by adaptive design type and desirable CI properties, offering practical guidance for statisticians interpreting results from adaptive trials.

Renard Triché L, Jabaudon M, Chevret S. Beyond the ventilator-free days: review of several estimands. Crit Care. 2025;29:343. doi:10.1186/s13054-025-05593-3

  • Summary: This review discusses the evolution and application of composite outcomes like ventilator-free days (VFDs) in critical care research, examining various statistical models—including competing risks, multistate, recurrent event, and mixture cure models—for analyzing VFDs, and emphasizes the importance of pre-specifying a suitable estimand and analytic approach tailored to the primary research objective of each study.

General Interest

Gerard R, Dewitte A, Gross F, Pradeu T, Lemoine M, Goret J, et al. Is “pre-sepsis” the new sepsis? A narrative review. PLoS Pathog. 2025 Jul 31;19(7):e1013372. doi: 10.1371/journal.ppat.1013372

  • Summary: This narrative review introduces the concept of “pre-sepsis”—a phase of early immune dysregulation before organ failure—suggesting that earlier detection and intervention could improve sepsis outcomes.

Noronha AK, T AM, Rupali P. Dengue encephalitis: what's new? Curr Opin Infect Dis. 2025 Jul 22. doi: 10.1097/QCO.0000000000001128

  • Summary: This review highlights new insights into the diagnosis, neuroimaging, and management of dengue encephalitis, emphasizing the importance of early recognition and distinctive MRI features for improved outcomes.

Guarino M, Costanzini A, Luppi F, Maritati M, Contini C, De Giorgio R, et al. Extracorporeal cytokine adsorption in sepsis: current evidence and future perspectives. Biomedicines. 2025 Jul 9;13(7):1684. doi: 10.3390/biomedicines13071684

  • Summary: This review explores current evidence and future directions for using extracorporeal cytokine adsorption as an adjunctive therapy in sepsis management.

Nian W, Tao W, Zhang H. Review of research progress in sepsis-associated acute kidney injury. Front Mol Biosci. 2025 Jul 11;12:1603392. doi: 10.3389/fmolb.2025.1603392

  • Summary: This review summarizes recent advances in the pathophysiology, diagnosis, therapy, and prognosis of sepsis-associated acute kidney injury, and highlights the potential of novel biomarkers and multi-omics approaches.

Thornton J. Rinaldo Bellomo. Lancet. 2025 Aug 2;406(10502):438. doi:10.1016/S0140-6736(25)01527-2

  • Summary: This obituary honors Rinaldo Bellomo, a pioneering intensive care physician and researcher whose work transformed critical care medicine worldwide.

Ajjampur SSR, Aruldas K, Ásbjörnsdóttir KH, Avokpaho E, Bailey R, Cottrell G, et al. Feasibility of interrupting the transmission of soil-transmitted helminths: the DeWorm3 community cluster-randomised controlled trial in Benin, India, and Malawi. Lancet. 2025 Aug 2;406(10502):475–488. doi:10.1016/S0140-6736(25)00766-4

  • Summary: This large cluster-randomised trial found that community-wide mass deworming can reduce soil-transmitted helminth prevalence, but complete transmission interruption may not be feasible within three years.

Fischer J. Why I did not become a cardiologist. Clin Infect Dis. 2025 Jul 15;81(1):5–6. doi:10.1093/cid/ciaf156

  • Summary: This reflective essay describes how personal experiences and public health challenges inspired a career in infectious diseases over more “prestigious “specialties.

Winkler AS, Brux CM, Carabin H, das Neves CG, Häsler B, Zinsstag J, et al. The Lancet One Health Commission: harnessing our interconnectedness for equitable, sustainable, and healthy socioecological systems. Lancet. 2025 Aug 2;406(10502):501–570. doi:10.1016/S0140-6736(25)00627-0

  • Summary: The Lancet One Health Commission advocates for an integrated, interdisciplinary approach to address global health and sustainability challenges through the One Health framework.

Sun YJ, Gong HB. Crusted scabies. N Engl J Med. 2025;393:e8. doi:10.1056/NEJMicm2503141

  • Summary: This clinical image report describes a case of crusted scabies in an immunocompromised patient, emphasizing its diagnosis and highly contagious nature.

Brown RF, Lopez K, Smith CB, Charles A. Diverticulitis: a review. JAMA. 2025 Jul 24. doi:10.1001/jama.2025.10234

  • Summary: This review covers epidemiology, risk factors, diagnosis, and management of diverticulitis, highlighting observation and pain control for uncomplicated cases and antibiotics for selected patients.

Maghsoudlou P, Epps SJ, Guly CM, Dick AD. Uveitis in adults: a review. JAMA. 2025;334(5):419-34. doi:10.1001/jama.2025.4358

  • Summary: This comprehensive review discusses the epidemiology, classification, complications, and treatment of uveitis in adults, emphasizing tailored therapy based on subtype and etiology.

Anderer S. The meningitis vaccine appears to protect against gonorrhea—scientists may now know why. JAMA. 2025;334(5):377-8. doi:10.1001/jama.2025.10102

  • Summary: This Medical News article discusses the discovery of antigens that may explain reductions in gonococcal infections following meningococcal B vaccination.

Kulkarni PS, Potey AV, Kapse D, Bhamare C, Gawande A, Munshi R, et al. Post-exposure prophylaxis regimen of rabies monoclonal antibody and vaccine in category 3 potential exposure patients: a phase 4, open-label, randomised, active-controlled trial. Lancet. 2025 Aug 9;406(10503):627-35. doi:10.1016/S0140-6736(25)00735-4

  • Summary: This phase 4, open-label randomized trial in India evaluated a post-exposure prophylaxis regimen of rabies monoclonal antibody (RmAb) plus purified Vero cell rabies vaccine (PVRV) versus equine rabies immunoglobulin plus PVRV in patients with category 3 rabies exposure, finding that the RmAb-based regimen was safe, immunogenic, and effective with no rabies cases during one-year follow-up, and adverse events were generally mild and transient, establishing RmAb as a reliable component of rabies prophylaxis.

Hicks MH, Tore M, Michard F, Khanna AK. Portable wireless monitoring of vital signs in hospital wards. BJA Educ. 2025 Jul;25(7):265-72. doi:10.1016/j.bjae.2025.04.004

  • Summary: This review discusses the limitations of intermittent vital sign monitoring in hospital wards, outlines the advantages and challenges of adopting portable wireless continuous monitoring systems—including improved detection of clinical deterioration, decreased ICU admissions, and reduced mortality—and highlights the need for user-friendly, integrated, and cost-effective solutions while addressing barriers like alarm fatigue, connectivity, and implementation costs.

Wang TK, Klein AL, Cremer PC, Imazio M, Kohnstamm S, Luis SA, et al. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the diagnosis and management of pericarditis: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2025 Aug 6. doi:10.1016/j.jacc.2025.05.023

  • Summary: This ACC Expert Consensus Statement presents concise clinical guidance for the diagnosis and management of pericarditis, forming part of the American College of Cardiology's integrated "solution set" approach to cardiovascular care by providing practical, actionable recommendations and decision tools to address current evidence gaps and streamline the implementation of best practices for specific patient populations.

Luther L, Maxson R, Stinner DJ. Negative pressure wound therapy in resource-limited environments: review and field guide. J Trauma Acute Care Surg. 2025 Aug;99(3S):S143-9. doi:10.1097/TA.0000000000004708

  • Summary: This review discusses the benefits and challenges of negative pressure wound therapy (NPWT) in managing traumatic wounds in resource-limited or austere environments, highlighting low-cost improvised alternatives, practical techniques for NPWT system construction, and offering a field guide to help clinicians deliver effective, evidence-based wound care where commercial NPWT products are unavailable or impractical.
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