Clinical Microbiology Reviews最新文献

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An unintended consequence: a review of iatrogenic central nervous system mold infections and outbreaks 意想不到的后果：医源性中枢神经系统霉菌感染和暴发的回顾

IF 36.8 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2026-02-10 DOI: 10.1128/cmr.00282-25

Chia-Yu ChiuRachel S. HicklenLuis Ostrosky-ZeichnerSunil A. ShethChunfeng TanJeffrey S. WeinbergTom ChillerThomas J. WalshDimitrios P. Kontoyiannis1Division of Infectious Diseases, Department of Medicine, University of Coloradohttps://ror.org/03gds6c39, Aurora, Colorado, USA2Research Medical Library, The University of Texas MD Anderson Cancer Center4002https://ror.org/04twxam07, Houston, Texas, USA3Division of Infectious Diseases, The University of Texas Health Science Center at Houston12340https://ror.org/03gds6c39, Houston, Texas, USA4Department of Neurology, The University of Texas Health Science Center at Houston12340https://ror.org/03gds6c39, Houston, Texas, USA5Department of Neurosurgery, The University of Texas MD Anderson Cancer Center4002https://ror.org/04twxam07, Houston, Texas, USA6IMMY, Norman, Oklahoma, USA7Departments of Medicine and Microbiology & Immunology, University of Maryland School of Medicine12264https://ror.org/04rq5mt64, Baltimore, Maryland, USA8Cente..

Clinical Microbiology Reviews, Ahead of Print.

临床微生物学评论，提前印刷。

引用次数: 0

Serratia species as paratransgenic vehicles: potential applications in vector-borne disease control 作为准转基因载体的沙雷菌：在媒介传播疾病控制中的潜在应用

IF 36.8 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2026-02-02 DOI: 10.1128/cmr.00280-25

Shivani MahorHimanshu Gupta1Department of Biotechnology, Institute of Applied Sciences & Humanities, GLA University231522https://ror.org/05fnxgv12, Mathura, Uttar Pradesh, IndiaJorge Cervantes

Clinical Microbiology Reviews, Ahead of Print.

临床微生物学评论，提前印刷。

引用次数: 0

Mechanisms of microbial colonization in biofilm-associated infections of hemodialysis catheters and advances in surface modification technologies. 血液透析导管生物膜相关感染的微生物定植机制及表面修饰技术进展。

IF 36.8 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2026-01-23 DOI: 10.1128/cmr.00283-25

Qiao-Qiao Zhou,Yu Wan

SUMMARYHemodialysis catheter-related bloodstream infections (CRBSIs), primarily driven by microbial colonization and biofilm formation, represent a major cause of morbidity and mortality in patients with end-stage renal disease. Key pathogens such as Staphylococcus aureus and Pseudomonas aeruginosa employ sophisticated virulence mechanisms, including microbial surface components recognizing adhesive matrix molecules (MSCRAMMs) and quorum-sensing (QS) systems, to establish resilient biofilms. Surface modification technologies-encompassing antibacterial coatings, antithrombotic modifications, antibiofilm technologies, surface topological optimization, and tip design innovations-offer promising "anti-colonization" strategies to prevent infections. Notably, while tunneled and non-tunneled catheters exhibit distinct biofilm dynamics and clinical risk profiles, emerging multifunctional coatings demonstrate the potential for enhancing long-term catheter safety and performance. However, the clinical translation of these innovations requires overcoming challenges related to biocompatibility, long-term durability, and scalable manufacturing, necessitating interdisciplinary collaboration.

血液透析导管相关血流感染（crbsi）主要由微生物定植和生物膜形成驱动，是终末期肾病患者发病和死亡的主要原因。关键病原体如金黄色葡萄球菌和铜绿假单胞菌采用复杂的毒力机制，包括识别粘附基质分子的微生物表面组分（msmrms）和群体感应（QS）系统，以建立弹性生物膜。表面修饰技术——包括抗菌涂层、抗血栓修饰、抗菌膜技术、表面拓扑优化和尖端设计创新——为预防感染提供了有前途的“抗定植”策略。值得注意的是，虽然隧道导管和非隧道导管表现出不同的生物膜动力学和临床风险特征，但新兴的多功能涂层显示出增强导管长期安全性和性能的潜力。然而，这些创新的临床转化需要克服与生物相容性、长期耐久性和可扩展制造相关的挑战，需要跨学科合作。

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引用次数: 0

Current knowledge and perspectives on the emerging Inquilinus limosus pathogen. 对新发褐毛线虫病原菌的认识现状及展望。

IF 36.8 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2026-01-07 DOI: 10.1128/cmr.00100-25

Eric Farfour,Audrey Brisebarre,Stéphane Corvec,Thomas Guillard

SUMMARYInquilinus limosus is a nonfermentative Gram-negative rod that has been reported as an emergent pathogen, particularly in chronic respiratory diseases. I. limosus was first isolated from the airways of a lung transplant patient suffering from cystic fibrosis (CF). As I. limosus is almost exclusively recovered from the airways of CF patients, its identification may be challenging for non-CF specialists. Indeed, I. limosus is mainly isolated from the airways of CF patients, and its pathogenesis and treatments are still debated. We have extensively reported and reviewed the different clinical cases described in the literature, the identification methods used, and the antimicrobial susceptibility testing performed. Therefore, we provide here an exhaustive description of the phenotypic features and antimicrobial susceptibilities of I. limosus. Only seven I. limosus genomes are currently available in public databases. These genomes are not fully assembled and therefore allow only partial genomic analyses, which could not unveil antimicrobial resistance determinants or virulence factors. They are approximately 7 Mb in size and encode between 6,036 and 7,483 genes. Given that the available genomes are incomplete, our genomic analyses are still limited and would undoubtedly benefit from further fully sequenced and annotated genomes to provide additional information on the antibiotic resistance and pathogenesis of I. limosus. We anticipate that our review will be a starting point for more genome sequencing studies, as well as epidemiological studies, to provide additional information on I. limosus for better management of patients.

摘要：limmosus是一种非发酵的革兰氏阴性棒，已被报道为一种新兴病原体，特别是在慢性呼吸道疾病中。I. limosus首先从患有囊性纤维化（CF）的肺移植患者的气道中分离出来。由于脓毒杆菌几乎完全从CF患者的气道中恢复，对于非CF专家来说，其鉴定可能具有挑战性。事实上，脓毒杆菌主要分离于CF患者的气道，其发病机制和治疗方法仍有争议。我们广泛报道和回顾了文献中描述的不同临床病例、使用的鉴定方法和进行的抗菌药物敏感性试验。因此，我们在这里提供了一个详尽的描述的表型特征和抗菌敏感性的I. limosus。目前在公共数据库中只有7个limosus基因组可用。这些基因组没有完全组装，因此只能进行部分基因组分析，无法揭示抗菌素耐药性决定因素或毒力因素。它们大约有7mb大小，编码6036到7483个基因。鉴于可用的基因组是不完整的，我们的基因组分析仍然是有限的，无疑将受益于进一步的全测序和注释基因组，以提供更多的抗生素耐药性和致病机制的信息。我们预计，我们的综述将成为更多基因组测序研究和流行病学研究的起点，为更好地管理患者提供更多关于limmosus的信息。

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引用次数: 0

The power of resistance: mechanisms of antimicrobial resistance in Mycobacterium tuberculosis and its impact on tuberculosis management. 耐药性的力量：结核分枝杆菌抗微生物药物耐药性机制及其对结核病管理的影响。

IF 36.8 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2026-01-07 DOI: 10.1128/cmr.00194-25

Radha Gopalaswamy,Selvakumar Subbian

SUMMARYThe global resurgence of drug-resistant tuberculosis (DR-TB) presents a formidable challenge to public health, driven by a complex interplay of mycobacterial evolution, dynamics and outcomes of host-pathogen interactions and systemic gaps in diagnosis and treatment strategies. This comprehensive review delineates the multifactorial basis of antimicrobial resistance (AMR) in Mycobacterium tuberculosis (Mtb), integrating molecular, immunological, and pharmacological perspectives to inform next-generation strategies for effective TB control. We reconceptualize TB as a dynamic clinical spectrum-ranging from asymptomatic infection to overt disease-shaped by granuloma biology and bacterial adaptation. This spectrum underpins both diagnostic ambiguity and therapeutic failure, particularly in the context of phenotypic drug tolerance/resistance to current anti-TB drugs. We discuss Mtb's intrinsic and extrinsic resistance mechanisms, including the lipid-rich cell envelope, efflux systems, and enzymatic drug modification, which are compounded by acquired mutations that disrupt drug activation, alter targets, and confer cross-resistance. These adaptations are further potentiated by granuloma-induced pharmacokinetic heterogeneity and host-induced metabolic quiescence. We highlight the emerging role of therapeutic drug monitoring and pharmacokinetic/pharmacodynamic modeling in optimizing individualized therapy, particularly for novel regimens incorporating bedaquiline, pretomanid, and linezolid. Moreover, we underscore the diagnostic limitations in detecting heteroresistance and early-stage disease, advocating for expanded deployment of advanced and targeted molecular diagnostic modalities. Finally, we propose a paradigm shift toward integrated, precision-based TB management, leveraging host-directed therapies, biofilm-disrupting agents, and real-time pharmacokinetics-guided dosing to preempt resistance emergence and improve clinical outcomes. This review provides a translational framework for addressing the biological and operational complexities of DR-TB in the era of AMR.

摘要：由于分枝杆菌进化、宿主-病原体相互作用的动态和结果的复杂相互作用以及诊断和治疗策略的系统性差距，全球耐药结核病（DR-TB）的重新抬头对公共卫生构成了巨大挑战。本综述概述了结核分枝杆菌（Mtb）抗微生物药物耐药性（AMR）的多因素基础，整合了分子、免疫学和药理学观点，为有效控制结核病的下一代策略提供信息。我们将结核病重新定义为一个动态的临床谱-从无症状感染到肉芽肿生物学和细菌适应形成的显性疾病。这一范围是诊断模糊和治疗失败的基础，特别是在对当前抗结核药物的表型耐药/耐药性的背景下。我们讨论了结核分枝杆菌的内在和外在耐药机制，包括富含脂质的细胞包膜、外排系统和酶促药物修饰，这些都是由获得性突变引起的，这些突变会破坏药物激活、改变靶标并赋予交叉耐药。肉芽肿诱导的药代动力学异质性和宿主诱导的代谢静止进一步增强了这些适应性。我们强调了治疗药物监测和药代动力学/药效学建模在优化个体化治疗中的新兴作用，特别是对于结合贝达喹啉、普雷托马尼和利奈唑胺的新方案。此外，我们强调在检测异源耐药和早期疾病方面的诊断局限性，提倡扩大先进和靶向分子诊断方式的部署。最后，我们提出了一种模式转变，即向综合的、基于精确的结核病管理转变，利用宿主导向治疗、生物膜破坏剂和实时药代动力学指导给药来预防耐药性的出现并改善临床结果。这篇综述为在AMR时代解决耐药结核病的生物学和操作复杂性提供了一个翻译框架。

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引用次数: 0

Comprehensive review and reflective evaluation of cell therapies for tuberculosis. 结核细胞治疗的综合回顾和反思评价。

IF 36.8 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2025-12-15 DOI: 10.1128/cmr.00232-25

Lan Zhao,Yao Zhang,Rui Liu,Beibei Ni,Lijun Bi

SUMMARYTuberculosis (TB) remains a major infectious disease threatening global health. An estimated 2 billion people worldwide are infected with Mycobacterium tuberculosis (Mtb), and 5-10% of those with latent infection will develop active TB. Despite the success of existing anti-TB drugs in controlling transmission, significant challenges remain, including long treatment durations, severe side effects, suboptimal treatment adherence, and inevitable drug resistance. Even newly developed drugs may fail to keep pace with the rising number of drug-resistant cases. Moreover, these treatments do not adequately address persistent lung dysfunction after cure. A primary reason for these therapeutic challenges in TB management may be that all current anti-TB drugs are solely aimed at achieving antibacterial, bacteriostatic, or bactericidal efficacy, which neglects the critical role of host cellular responses during disease progression. Future strategies should explore the potential of cell-based therapies, an area that has received limited attention in previous reviews. From the perspective of cell therapy, this article comprehensively reviews key clinical studies, animal models, and in vitro experiments from recent decades that utilized cells or cytokines for TB treatment, providing clinicians and researchers with a unique perspective and support for developing more integrated therapeutic strategies toward ending TB.

结核病（TB）仍然是威胁全球健康的主要传染病。据估计，全世界有20亿人感染结核分枝杆菌（Mtb），潜伏感染者中有5-10%会发展为活动性结核病。尽管现有的抗结核药物在控制传播方面取得了成功，但仍然存在重大挑战，包括治疗持续时间长、副作用严重、治疗依从性欠佳以及不可避免的耐药性。即使是新开发的药物也可能无法跟上不断增加的耐药病例。此外，这些治疗不能充分解决治愈后持续的肺功能障碍。结核病管理中存在这些治疗挑战的一个主要原因可能是，目前所有抗结核药物都仅针对实现抗菌、抑菌或杀菌功效，而忽视了疾病进展过程中宿主细胞反应的关键作用。未来的策略应该探索细胞疗法的潜力，这一领域在以前的综述中受到的关注有限。本文从细胞治疗的角度，全面回顾了近几十年来利用细胞或细胞因子治疗结核病的关键临床研究、动物模型和体外实验，为临床医生和研究人员制定更综合的治疗策略提供了独特的视角和支持。

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引用次数: 0

Dengue and severe dengue. 登革热和重症登革热。

IF 19.3 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2025-12-11 Epub Date: 2025-09-05 DOI: 10.1128/cmr.00244-24

Shirin Kalimuddin, Po Ying Chia, Jenny G Low, Eng Eong Ooi

SUMMARYDengue is an acute mosquito-borne viral disease that is highly prevalent throughout the tropical world. The geographic footprint of the four dengue viruses (DENV-1 to -4) that cause this disease and their Aedes mosquito vector is expanding, extending into North America and Mediterranean Europe. Furthermore, although dengue has historically been a disease that disproportionately affects children, changing population demographics and increasing travel to and from the tropics have contributed to a growing incidence in adults. Dengue in adults, particularly older adults, brings fresh and complex challenges to case management. Although dengue is now a vaccine-preventable disease, the efficacy profiles of licensed vaccines as well as those in late-stage clinical development suggest that vaccination alone would not fully retard the global expansion of dengue. Other countermeasures, including antiviral drugs, will be needed. This paper reviews the molecular interplay underlying dengue pathogenesis, including from virological and immunological perspectives, which are foundational for developing antiviral therapies and new vaccines. It also reviews the hurdles facing antiviral development and discusses new insights on dengue immunity that can guide the deployment of imperfect vaccines to begin reversing the global burden of dengue.

登革热是一种急性蚊媒病毒性疾病，在热带世界高度流行。导致这种疾病的四种登革热病毒（DENV-1至-4）及其媒介伊蚊的地理足迹正在扩大，延伸到北美和地中海欧洲。此外，虽然登革热历来是一种严重影响儿童的疾病，但人口结构的变化和往返热带地区的旅行增加导致成人发病率不断上升。成人，特别是老年人的登革热给病例管理带来了新的和复杂的挑战。虽然登革热现在是一种疫苗可预防的疾病，但许可疫苗的功效概况以及处于后期临床开发阶段的疫苗表明，仅靠接种疫苗并不能完全阻止登革热在全球的蔓延。还需要其他对策，包括抗病毒药物。本文综述了登革热发病机制中的分子相互作用，包括病毒学和免疫学的观点，这是开发抗病毒治疗和新疫苗的基础。它还审查了抗病毒药物开发面临的障碍，并讨论了关于登革热免疫的新见解，这些见解可以指导部署不完善的疫苗，以开始扭转登革热的全球负担。

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引用次数: 0

2025 Acknowledgment of CMR Reviewers 2025 CMR审稿人致谢

IF 36.8 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2025-12-11 DOI: 10.1128/cmr.00287-25

Graeme Forrest 1 Rush University Medical Center 2468 https://ror.org/01j7c0b24 , Chicago, Illinois, USA

Clinical Microbiology Reviews, Volume 38, Issue 4, December 2025.

临床微生物学评论，38卷，第4期，2025年12月。

引用次数: 0

An update on clinically relevant, rare, and emerging Candida and Saccharomycotina yeasts that have been recently reclassified from Candida. 最近从念珠菌中重新分类的临床相关的，罕见的和新兴的念珠菌和酵母菌属酵母的更新。

IF 19.3 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2025-12-11 Epub Date: 2025-09-03 DOI: 10.1128/cmr.00064-23

Elaine Cristina Francisco, Diego H Caceres, José Guillermo Pereira Brunelli, Guillermo Garcia-Effron, Amir Arastehfar, Felipe de Camargo Ribeiro, Matheus Naves de Almeida, Sarah Santos Gonçalves, João Nóbrega de Almeida, Cornelia Lass-Flörl, Teun Boekhout, Arnaldo Lopes Colombo

SUMMARYMany yeast species causing life-threatening invasive infections that were formerly classified in the genus Candida have been reclassified due to their evolutionary and phylogenetic relationships elucidated by DNA sequencing methods that are increasingly using whole genomes. This review explores the evolving taxonomy, epidemiology, and clinical implications of clinically relevant, rare, emerging Candida and Saccharomycotina yeasts that have recently been reclassified from Candida. This article highlights the urgent need for intensified research efforts to enhance knowledge and improve outcomes in the management of infections caused by these yeasts. Communicating results from molecular phylogenetic studies of yeasts, which lead to their reclassification, is of great importance to the medical mycology community to implement such results in clinical practice.

许多引起危及生命的侵袭性感染的酵母菌物种以前被分类为念珠菌属，由于它们的进化和系统发育关系被越来越多地使用全基因组的DNA测序方法所阐明，因此被重新分类。这篇综述探讨了最近从念珠菌中重新分类的临床相关的、罕见的、新兴的念珠菌和Saccharomycotina酵母的分类、流行病学和临床意义。这篇文章强调了迫切需要加强研究工作，以提高知识和改善这些酵母菌引起的感染管理的结果。将酵母分子系统发育研究的结果进行交流，从而对其进行重新分类，对于医学真菌学界将这些结果应用于临床实践非常重要。

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引用次数: 0

The oral penems and carbapenems. 口服青霉烯类和碳青霉烯类。

IF 19.3 1区医学 Q1 MICROBIOLOGY

Clinical Microbiology Reviews

Pub Date : 2025-12-11 Epub Date: 2025-09-03 DOI: 10.1128/cmr.00042-24

Sena Sayood, Elizabeth Neuner, Rebekah Dumm, Sumanth Gandra

SUMMARYThe penem and carbapenem antibiotics provide some of the broadest spectrum coverage available and generally should only be used when narrower options are unavailable. The majority of available carbapenems can only be administered parenterally, but two orally administered penems (faropenem and sulopenem) and one orally administered carbapenem (tebipenem) are in increased use due to approvals in new markets. These oral agents have a spectrum of activity similar to widely used parenteral carbapenems but are simpler to administer than intravenous agents and will likely experience rapid increases in their rates of use as they are approved in new markets. In this review, we discuss their spectra of activity, pharmacokinetics, pharmacodynamics, clinical efficacy, toxicity, antimicrobial stewardship considerations, and potential clinical applications.

培南类和碳青霉烯类抗生素提供了一些最广泛的可用范围，通常仅在无法获得较窄范围的选择时才应使用。大多数可用的碳青霉烯类药物只能通过肠外给药，但由于新市场的批准，两种口服的碳青霉烯类药物（法罗培南和苏罗培南）和一种口服的碳青霉烯类药物（特比培南）的使用正在增加。这些口服药物具有与广泛使用的外注射碳青霉烯类药物相似的活性谱，但比静脉注射药物更容易管理，并且随着它们在新市场获得批准，其使用率可能会迅速增加。在这篇综述中，我们讨论了它们的活性谱、药代动力学、药效学、临床疗效、毒性、抗菌药物管理注意事项和潜在的临床应用。

引用次数: 0

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