SUMMARYStreptococcus pneumoniae (S. pneumoniae) is a major human pathogen that can cause severe diseases such as meningitis and bacteremia. β-lactam antibiotics are the most essential antimicrobial agents for treating S. pneumoniae infections, but the resistance has become a significant challenge in clinical therapy. Analyses reveal notable regional disparities in the prevalence of β-lactam resistance in S. pneumoniae. The use of pneumococcal conjugate vaccines effectively reduces the spread of highly resistant clones, indirectly improving resistance patterns. Interestingly, resistance is inversely correlated with bacterial invasiveness, suggesting mutual selective pressures. Additionally, the COVID-19 pandemic may have influenced the evolution of S. pneumoniae resistance by altering host immune states and healthcare resource allocation. Immunocompromised patients face a higher risk of invasive pneumococcal disease, driving increased antimicrobial use that fuels the rise of resistance. Beyond the single-molecular mechanism, the resistance gene acquisition order plays a critical role in the successful resistance evolution. Analyzing the dynamic principles and key nodes involved in the evolution of drug resistance could offer novel insights for developing precise antibacterial treatment strategies. Current research efforts focus on the development of novel antibiotics, antimicrobial peptides, lysins, and other innovative therapeutic agents. Artificial intelligence shows immense potential in the screening of antimicrobial drugs and the prediction of resistance mechanisms. This review synthesizes recent advances in the epidemiology, molecular mechanisms, and management of β-lactam resistance in S. pneumoniae, with the aim of informing evidence-based antimicrobial stewardship and accelerating the development of innovative therapeutics to combat this evolving public health threat.
{"title":"Streptococcus pneumoniae β-lactam resistance: epidemiological trends, molecular drivers, and innovative control strategies in the post-pandemic era.","authors":"Jiaqi Li,Guixue Cheng,Xiaosong Qin,Jianhua Liu","doi":"10.1128/cmr.00082-25","DOIUrl":"https://doi.org/10.1128/cmr.00082-25","url":null,"abstract":"SUMMARYStreptococcus pneumoniae (S. pneumoniae) is a major human pathogen that can cause severe diseases such as meningitis and bacteremia. β-lactam antibiotics are the most essential antimicrobial agents for treating S. pneumoniae infections, but the resistance has become a significant challenge in clinical therapy. Analyses reveal notable regional disparities in the prevalence of β-lactam resistance in S. pneumoniae. The use of pneumococcal conjugate vaccines effectively reduces the spread of highly resistant clones, indirectly improving resistance patterns. Interestingly, resistance is inversely correlated with bacterial invasiveness, suggesting mutual selective pressures. Additionally, the COVID-19 pandemic may have influenced the evolution of S. pneumoniae resistance by altering host immune states and healthcare resource allocation. Immunocompromised patients face a higher risk of invasive pneumococcal disease, driving increased antimicrobial use that fuels the rise of resistance. Beyond the single-molecular mechanism, the resistance gene acquisition order plays a critical role in the successful resistance evolution. Analyzing the dynamic principles and key nodes involved in the evolution of drug resistance could offer novel insights for developing precise antibacterial treatment strategies. Current research efforts focus on the development of novel antibiotics, antimicrobial peptides, lysins, and other innovative therapeutic agents. Artificial intelligence shows immense potential in the screening of antimicrobial drugs and the prediction of resistance mechanisms. This review synthesizes recent advances in the epidemiology, molecular mechanisms, and management of β-lactam resistance in S. pneumoniae, with the aim of informing evidence-based antimicrobial stewardship and accelerating the development of innovative therapeutics to combat this evolving public health threat.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"31 1","pages":"e0008225"},"PeriodicalIF":36.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144747763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Piotr P Janas,Christoforos Rozario,Christopher D Lucas,Pieter S Hiemstra,Jürgen Schwarze,Caroline Chauché
SUMMARYRespiratory viral infections cause extensive cell death in the lung epithelium, resulting from both direct viral action and exuberant immune responses. Recovery following viral infection requires rapid and coordinated repair programs, ensuring the replacement of the damaged tissue through proliferation, migration, and differentiation of respiratory epithelial progenitor cells. Viral infection and the resulting inflammatory milieu alter host gene expression. Notably, growing evidence indicates that these infections can induce long-term changes in epithelial progenitor cells, which persist even after the infection has resolved. These alterations may play a key role in the development of post-viral lung disease (PVLD). In this review, we discuss current knowledge regarding respiratory viral infections and how these may alter the gene expression and function of epithelial progeny cells arising from the surviving progenitors. We do so by exploring the influenza virus as an example and comparing it with what is known about other important respiratory viruses, such as respiratory syncytial virus (RSV), rhinovirus (HRV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). We highlight the impact of respiratory viral infection and ensuing inflammation on lung epithelial memory, considering the importance of viral strains, and discuss potential new therapeutic strategies that could maximize long-term lung health.
{"title":"The long reach of influenza and other respiratory viruses: from acute epithelial injury to post-viral lung disease.","authors":"Piotr P Janas,Christoforos Rozario,Christopher D Lucas,Pieter S Hiemstra,Jürgen Schwarze,Caroline Chauché","doi":"10.1128/cmr.00243-24","DOIUrl":"https://doi.org/10.1128/cmr.00243-24","url":null,"abstract":"SUMMARYRespiratory viral infections cause extensive cell death in the lung epithelium, resulting from both direct viral action and exuberant immune responses. Recovery following viral infection requires rapid and coordinated repair programs, ensuring the replacement of the damaged tissue through proliferation, migration, and differentiation of respiratory epithelial progenitor cells. Viral infection and the resulting inflammatory milieu alter host gene expression. Notably, growing evidence indicates that these infections can induce long-term changes in epithelial progenitor cells, which persist even after the infection has resolved. These alterations may play a key role in the development of post-viral lung disease (PVLD). In this review, we discuss current knowledge regarding respiratory viral infections and how these may alter the gene expression and function of epithelial progeny cells arising from the surviving progenitors. We do so by exploring the influenza virus as an example and comparing it with what is known about other important respiratory viruses, such as respiratory syncytial virus (RSV), rhinovirus (HRV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). We highlight the impact of respiratory viral infection and ensuing inflammation on lung epithelial memory, considering the importance of viral strains, and discuss potential new therapeutic strategies that could maximize long-term lung health.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"46 48 1","pages":"e0024324"},"PeriodicalIF":36.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R S Tambovtseva,L A Arslan,T A Grigoryeva,S R Abdulkhakov,Y V Doludin,I O Stoma,A A Rizvanov,R R Miftakhova,A G Gabdoulkhakova
SUMMARYThe pathogenesis of ulcerative colitis (UC) is heterogeneous; the causes are considered to be external factors such as stress, infections, antibiotics, and other medications, diet, and intrinsic factors such as genetic predisposition. The aim of this narrative review is to analyze data on intestinal flora and bacteria-derived metabolites in inflammatory bowel diseases and ulcerative colitis in particular. The main focus is on proteolytic, saccharolytic, mucin-degrading, and bile acid-metabolizing bacteria. What types of metabolites are beneficial for intestinal integrity and the patient's health? How can dietary preferences trigger disease and cause complications? What kind of changes in the microbiome promote the disease? We consider what targets/receptors metabolites act on and their physiological role. The knowledge accumulated over the past years on the gut metagenome, metabolome, and signaling mechanisms may allow, in the future, modulating the composition of the intestinal microbiome and suppressing the growth of pathogenic flora without the use of antibiotics, but due to pro- and prebiotics, products of bacterial metabolism, including quorum sensing molecules.
{"title":"Narrative review on bacteria-derived metabolites in the pathogenesis of ulcerative colitis.","authors":"R S Tambovtseva,L A Arslan,T A Grigoryeva,S R Abdulkhakov,Y V Doludin,I O Stoma,A A Rizvanov,R R Miftakhova,A G Gabdoulkhakova","doi":"10.1128/cmr.00210-24","DOIUrl":"https://doi.org/10.1128/cmr.00210-24","url":null,"abstract":"SUMMARYThe pathogenesis of ulcerative colitis (UC) is heterogeneous; the causes are considered to be external factors such as stress, infections, antibiotics, and other medications, diet, and intrinsic factors such as genetic predisposition. The aim of this narrative review is to analyze data on intestinal flora and bacteria-derived metabolites in inflammatory bowel diseases and ulcerative colitis in particular. The main focus is on proteolytic, saccharolytic, mucin-degrading, and bile acid-metabolizing bacteria. What types of metabolites are beneficial for intestinal integrity and the patient's health? How can dietary preferences trigger disease and cause complications? What kind of changes in the microbiome promote the disease? We consider what targets/receptors metabolites act on and their physiological role. The knowledge accumulated over the past years on the gut metagenome, metabolome, and signaling mechanisms may allow, in the future, modulating the composition of the intestinal microbiome and suppressing the growth of pathogenic flora without the use of antibiotics, but due to pro- and prebiotics, products of bacterial metabolism, including quorum sensing molecules.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"103 1","pages":"e0021024"},"PeriodicalIF":36.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mark K. SlifkaArchana ThomasLina GaoIan J. AmannaWalter A. Orenstein1Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University466995, Beaverton, Oregon, USA2Biostatistics and Bioinformatics Core, Oregon National Primate Research Center, Biostatistics Shared Resource, Knight Cancer Institutehttps://ror.org/05fcfqq67, Portland, Oregon, USA3Najít Technologies, Inchttps://ror.org/002shna07, Beaverton, Oregon, USA4Emory Vaccine Center, Emory University1371https://ror.org/03czfpz43, Atlanta, Georgia, USAGraeme N. Forrest
Clinical Microbiology Reviews, Ahead of Print.
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{"title":"Lessons learned from successful implementation of tetanus and diphtheria vaccination programs","authors":"Mark K. SlifkaArchana ThomasLina GaoIan J. AmannaWalter A. Orenstein1Division of Neuroscience, Oregon National Primate Research Center, Oregon Health & Science University466995, Beaverton, Oregon, USA2Biostatistics and Bioinformatics Core, Oregon National Primate Research Center, Biostatistics Shared Resource, Knight Cancer Institutehttps://ror.org/05fcfqq67, Portland, Oregon, USA3Najít Technologies, Inchttps://ror.org/002shna07, Beaverton, Oregon, USA4Emory Vaccine Center, Emory University1371https://ror.org/03czfpz43, Atlanta, Georgia, USAGraeme N. Forrest","doi":"10.1128/cmr.00031-25","DOIUrl":"https://doi.org/10.1128/cmr.00031-25","url":null,"abstract":"Clinical Microbiology Reviews, Ahead of Print. <br/>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"23 1","pages":""},"PeriodicalIF":36.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SUMMARYSchistosomiasis occurs in 80 primarily tropical and subtropical countries. It is transmitted to humans and animals by Schistosoma cercariae during freshwater contact. Parasite stages adapt and switch between molluscs, water, and mammals, where worms sustain parasitism. We reviewed research on larvae encountering humans published in PubMed, Embase, and Web of Science until May 2024. Larvae perform intermittent active/tail-first and passive/body-first swimming with arc-like re-encountering upon host approaches. Skin contacts occur spontaneously or through stimulants. Schistosoma mansoni, expressing chemokinesis, lingers in upper-middle warm clear water. Schistosoma haematobium, showing negative photo-orientation, remains in upper-lower, cooler, clear-muddy freshwater. Schistosoma japonicum stays stimuli-wise non-responsive in shallow muddy habitats. Attachment triggers of S. mansoni and S. haematobium are amino acids and temperature, respectively. S. japonicum adheres at random. Temperature gradient, ceramides, and acylglycerols stimulate the epidermal remaining of S. mansoni; solid hydrophobic surfaces trigger S. haematobium and S. japonicum. Temperatures of ≥36°C, ≥40°C, and 37°C guide S. mansoni, S. haematobium, and S. japonicum creeping for entering. Permeation aligns with schistosomula transformation by glycocalyx removal, heptalaminate membrane conversion, and tail stripping off and advances mechanically and enzymatically through acetabular glands. Skin and bloodstream navigation follows increasing L-arginine and D-glucose and parasite adjustment ventral-wards. Head gland enzymes facilitate epidermal-dermal transitioning for cutaneous exiting and vasculature accessing. Skin responds with anti-parasitic, anti-inflammatory edematous infiltrations. Schistosoma reacts by evasion through hormones, neurotransmitters, enzymes, and specialized proteins, among others. The findings, building largely on in vitro experiments, aim to facilitate the development of field-suitable prevention and control measures in support of the World Health Organization 2021-2030 Roadmap on Neglected Tropical Diseases.
血吸虫病主要发生在80个热带和亚热带国家。该病在淡水接触过程中通过尾蚴血吸虫传播给人类和动物。寄生虫阶段适应并在软体动物、水生动物和哺乳动物之间切换，其中蠕虫维持寄生。我们回顾了截至2024年5月在PubMed， Embase和Web of Science上发表的关于幼虫与人类接触的研究。幼虫进行间歇性的主动/尾巴优先和被动/身体优先的游泳，在宿主接近时进行弧形的再相遇。皮肤接触是自发或通过兴奋剂发生的。曼氏血吸虫表现趋化作用，在中上温清澈水中徘徊。血血吸虫呈负向光性，在上、下、冷、清浊的淡水中存活。日本血吸虫（Schistosoma japonicum）在浅泥泞的生境中保持对刺激的无反应。mansoni和haematobium的附着触发因子分别是氨基酸和温度。日本血吸虫随机附着。温度梯度、神经酰胺和酰基甘油刺激曼陀罗表皮残留；固体疏水性表面触发了血孢链球菌和日本血吸虫。温度≥36°C，≥40°C和37°C引导mansoni， S. haematobium和S. japonicum匍匐进入。渗透与血吸虫通过去除糖萼、七胺酸膜转化和尾部剥离的转化一致，并通过髋臼腺以机械和酶的方式推进。皮肤和血液导航随着l-精氨酸和d -葡萄糖的增加和腹侧寄生虫调节而增加。头腺酶促进表皮到真皮的过渡，使皮肤流出和血管进入。皮肤反应抗寄生虫，消炎水肿浸润。血吸虫的反应是通过激素、神经递质、酶和特殊蛋白质等进行逃避。这些发现主要建立在体外实验的基础上，旨在促进制定适合现场的预防和控制措施，以支持世界卫生组织《2021-2030年被忽视热带病路线图》。
{"title":"Schistosomiasis: cercarial finding and recognizing of human hosts as a prerequisite of invasion.","authors":"Ursula Panzner,Jürg Utzinger,Jennifer Keiser","doi":"10.1128/cmr.00196-24","DOIUrl":"https://doi.org/10.1128/cmr.00196-24","url":null,"abstract":"SUMMARYSchistosomiasis occurs in 80 primarily tropical and subtropical countries. It is transmitted to humans and animals by Schistosoma cercariae during freshwater contact. Parasite stages adapt and switch between molluscs, water, and mammals, where worms sustain parasitism. We reviewed research on larvae encountering humans published in PubMed, Embase, and Web of Science until May 2024. Larvae perform intermittent active/tail-first and passive/body-first swimming with arc-like re-encountering upon host approaches. Skin contacts occur spontaneously or through stimulants. Schistosoma mansoni, expressing chemokinesis, lingers in upper-middle warm clear water. Schistosoma haematobium, showing negative photo-orientation, remains in upper-lower, cooler, clear-muddy freshwater. Schistosoma japonicum stays stimuli-wise non-responsive in shallow muddy habitats. Attachment triggers of S. mansoni and S. haematobium are amino acids and temperature, respectively. S. japonicum adheres at random. Temperature gradient, ceramides, and acylglycerols stimulate the epidermal remaining of S. mansoni; solid hydrophobic surfaces trigger S. haematobium and S. japonicum. Temperatures of ≥36°C, ≥40°C, and 37°C guide S. mansoni, S. haematobium, and S. japonicum creeping for entering. Permeation aligns with schistosomula transformation by glycocalyx removal, heptalaminate membrane conversion, and tail stripping off and advances mechanically and enzymatically through acetabular glands. Skin and bloodstream navigation follows increasing L-arginine and D-glucose and parasite adjustment ventral-wards. Head gland enzymes facilitate epidermal-dermal transitioning for cutaneous exiting and vasculature accessing. Skin responds with anti-parasitic, anti-inflammatory edematous infiltrations. Schistosoma reacts by evasion through hormones, neurotransmitters, enzymes, and specialized proteins, among others. The findings, building largely on in vitro experiments, aim to facilitate the development of field-suitable prevention and control measures in support of the World Health Organization 2021-2030 Roadmap on Neglected Tropical Diseases.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"153 1","pages":"e0019624"},"PeriodicalIF":36.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144578796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eleanor M. MarshallLuisa BarzonMarion KoopmansBarry Rockx1Department of Viroscience, Erasmus Medical Center6993https://ror.org/018906e22, Rotterdam, the Netherlands2Department of Molecular Medicine, University of Padovahttps://ror.org/00240q980, Padua, ItalyLara J. HerreroManjula KaliaJonathan Teetsel
Clinical Microbiology Reviews, Ahead of Print.
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{"title":"Extrapolation and comparison of West Nile virus- and Usutu virus-associated neurological diseases in humans: linking pathology to clinical symptoms","authors":"Eleanor M. MarshallLuisa BarzonMarion KoopmansBarry Rockx1Department of Viroscience, Erasmus Medical Center6993https://ror.org/018906e22, Rotterdam, the Netherlands2Department of Molecular Medicine, University of Padovahttps://ror.org/00240q980, Padua, ItalyLara J. HerreroManjula KaliaJonathan Teetsel","doi":"10.1128/cmr.00232-24","DOIUrl":"https://doi.org/10.1128/cmr.00232-24","url":null,"abstract":"Clinical Microbiology Reviews, Ahead of Print. <br/>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"11 1","pages":""},"PeriodicalIF":36.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donna M Wolk,J Scott Parrott,N Esther Babady,A Brian Mochon,Ryan Tom,Christen Diel,Jennifer Dien Bard,Amanda Harrington,D Jane Hata,Amity L Roberts,Lindsay Boyce,J Kristie Johnson
SUMMARYBloodstream infections (BSIs) are a significant cause of mortality and morbidity. Rapid identification of pathogens and detection of a few resistance markers from positive blood cultures are now possible through the increased availability of commercial rapid diagnostic tests, including nucleic acid amplification tests and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. This document describes the clinical utility of rapid diagnostics performed on positive blood cultures and provides evidence-based laboratory medicine guidelines for using rapid tests to diagnose BSIs in hospitalized adult and pediatric patients. This guideline was developed for use by medical (a.k.a. clinical) microbiologists, medical laboratory professionals, infectious disease clinicians, pharmacists, hospital administrators, healthcare providers, and other stakeholders associated with BSIs. A panel of experts, including medical microbiologists and experts in systematic literature review, was assembled to formulate the Population-Intervention-Comparison-Outcome (PICO) question, review the literature, and provide recommendations for using rapid tests to diagnose BSI and improve patient outcomes. A comprehensive literature search of four electronic bibliographic databases (MEDLINE, Embase, CINAHL, and Cochrane) was conducted to identify studies with measurable outcomes. The panel followed a systematic process, which included a standardized methodology for rating the certainty of the evidence and strength of recommendations using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. The panel evaluated the literature to answer the question: Does using rapid diagnostic tests improve clinical outcomes in adult and pediatric patients hospitalized with a BSI? Peer-reviewed literature was available to address three outcomes, including time to targeted therapy, mortality, and length of hospital stay. In general, the quality of the evidence was low to moderate due to the paucity of controlled, randomized clinical trial studies. However, eight recommendations were made based on evidence derived from the systematic review of the published literature. To answer the PICO question, the expert committee recommended using rapid diagnostic tests combined with active communication to decrease the time to targeted therapy and length of stay (strong recommendation). While the strength of the evidence for the impact on mortality is low, the panel supports using rapid tests to impact these outcomes. A summary of the recommendations is listed in the Executive Summary, which includes a detailed description of the background, methods, evidence summary, and rationale that supports each recommendation in the full text.
{"title":"The American Society for Microbiology's evidence-based laboratory medicine practice guidelines for the diagnosis of bloodstream infections using rapid tests: a systematic review and meta-analysis.","authors":"Donna M Wolk,J Scott Parrott,N Esther Babady,A Brian Mochon,Ryan Tom,Christen Diel,Jennifer Dien Bard,Amanda Harrington,D Jane Hata,Amity L Roberts,Lindsay Boyce,J Kristie Johnson","doi":"10.1128/cmr.00137-24","DOIUrl":"https://doi.org/10.1128/cmr.00137-24","url":null,"abstract":"SUMMARYBloodstream infections (BSIs) are a significant cause of mortality and morbidity. Rapid identification of pathogens and detection of a few resistance markers from positive blood cultures are now possible through the increased availability of commercial rapid diagnostic tests, including nucleic acid amplification tests and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. This document describes the clinical utility of rapid diagnostics performed on positive blood cultures and provides evidence-based laboratory medicine guidelines for using rapid tests to diagnose BSIs in hospitalized adult and pediatric patients. This guideline was developed for use by medical (a.k.a. clinical) microbiologists, medical laboratory professionals, infectious disease clinicians, pharmacists, hospital administrators, healthcare providers, and other stakeholders associated with BSIs. A panel of experts, including medical microbiologists and experts in systematic literature review, was assembled to formulate the Population-Intervention-Comparison-Outcome (PICO) question, review the literature, and provide recommendations for using rapid tests to diagnose BSI and improve patient outcomes. A comprehensive literature search of four electronic bibliographic databases (MEDLINE, Embase, CINAHL, and Cochrane) was conducted to identify studies with measurable outcomes. The panel followed a systematic process, which included a standardized methodology for rating the certainty of the evidence and strength of recommendations using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. The panel evaluated the literature to answer the question: Does using rapid diagnostic tests improve clinical outcomes in adult and pediatric patients hospitalized with a BSI? Peer-reviewed literature was available to address three outcomes, including time to targeted therapy, mortality, and length of hospital stay. In general, the quality of the evidence was low to moderate due to the paucity of controlled, randomized clinical trial studies. However, eight recommendations were made based on evidence derived from the systematic review of the published literature. To answer the PICO question, the expert committee recommended using rapid diagnostic tests combined with active communication to decrease the time to targeted therapy and length of stay (strong recommendation). While the strength of the evidence for the impact on mortality is low, the panel supports using rapid tests to impact these outcomes. A summary of the recommendations is listed in the Executive Summary, which includes a detailed description of the background, methods, evidence summary, and rationale that supports each recommendation in the full text.","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":"91 1","pages":"e0013724"},"PeriodicalIF":36.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-12Epub Date: 2025-02-27DOI: 10.1128/cmr.00043-25
Patrick D Schloss
{"title":"A call for healing and unity.","authors":"Patrick D Schloss","doi":"10.1128/cmr.00043-25","DOIUrl":"10.1128/cmr.00043-25","url":null,"abstract":"","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0004325"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-12Epub Date: 2025-03-20DOI: 10.1128/cmr.00212-24
Ni Jian, Lei Yu, Lijuan Ma, Binbin Zheng, Weiren Huang
SUMMARYBacillus Calmette-Guérin (BCG) has been the standard treatment for non-muscle-invasive bladder cancer for over 30 years. Despite its proven efficacy, challenges persist, including unclear mechanisms of action, resistance in 30%-50% of patients, and significant side effects. This review presents an updated and balanced discussion of the antitumor mechanisms of BCG, focusing on its direct effects on bladder cancer and its interactions with various cell types within the bladder tumor microenvironment. Notably, recent research on the interactions between BCG and the bladder microbiome is also incorporated. We further summarize and analyze the latest preclinical and clinical studies regarding both intrinsic and adaptive resistance to BCG in bladder cancer. Based on the current understanding of BCG's therapeutic principles and resistance mechanisms, we systematically explore strategies to improve BCG-based tumor immunotherapy. These include the development of recombinant BCG, combination therapy with different drugs, optimization of therapeutic regimens and management, and the exploration of new approaches by targeting changes in the bladder microbiota and its metabolites. These measures aim to effectively address the BCG resistance in bladder cancer, reduce its toxicity, and ultimately enhance the clinical anti-tumor efficacy. Bacterial therapy, represented by genetically engineered oncolytic bacteria, has gradually emerged in the field of cancer treatment in recent years. As the only bacterial drug successfully approved for oncology use, BCG has provided decades of clinical experience. By consolidating lessons from BCG's successes and limitations, we hope to provide valuable insights for the development and application of bacterial therapies in cancer treatment.
{"title":"BCG therapy in bladder cancer and its tumor microenvironment interactions.","authors":"Ni Jian, Lei Yu, Lijuan Ma, Binbin Zheng, Weiren Huang","doi":"10.1128/cmr.00212-24","DOIUrl":"10.1128/cmr.00212-24","url":null,"abstract":"<p><p>SUMMARYBacillus Calmette-Guérin (BCG) has been the standard treatment for non-muscle-invasive bladder cancer for over 30 years. Despite its proven efficacy, challenges persist, including unclear mechanisms of action, resistance in 30%-50% of patients, and significant side effects. This review presents an updated and balanced discussion of the antitumor mechanisms of BCG, focusing on its direct effects on bladder cancer and its interactions with various cell types within the bladder tumor microenvironment. Notably, recent research on the interactions between BCG and the bladder microbiome is also incorporated. We further summarize and analyze the latest preclinical and clinical studies regarding both intrinsic and adaptive resistance to BCG in bladder cancer. Based on the current understanding of BCG's therapeutic principles and resistance mechanisms, we systematically explore strategies to improve BCG-based tumor immunotherapy. These include the development of recombinant BCG, combination therapy with different drugs, optimization of therapeutic regimens and management, and the exploration of new approaches by targeting changes in the bladder microbiota and its metabolites. These measures aim to effectively address the BCG resistance in bladder cancer, reduce its toxicity, and ultimately enhance the clinical anti-tumor efficacy. Bacterial therapy, represented by genetically engineered oncolytic bacteria, has gradually emerged in the field of cancer treatment in recent years. As the only bacterial drug successfully approved for oncology use, BCG has provided decades of clinical experience. By consolidating lessons from BCG's successes and limitations, we hope to provide valuable insights for the development and application of bacterial therapies in cancer treatment.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0021224"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-12Epub Date: 2025-04-02DOI: 10.1128/cmr.00126-23
Dziedzom K de Souza, Moses J Bockarie
SUMMARYLymphatic filariasis (LF), a debilitating tropical disease caused by parasitic filarial worms, Wuchereria bancrofti, Brugia malayi, and Brugia timori, remains a significant public health challenge in tropical and subtropical settings where the disease is endemic. The disease affects millions worldwide, leading to severe disability and social stigma. Following the World Health Assembly resolution WHA50.29 in 1997 encouraging Member States to eliminate LF as a public health problem, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) was established in 2000. The establishment of the GPELF paced the way for global eradication efforts, with commitments from non-governmental organizations and Merck donating the drug ivermectin as long as it is needed to control the disease. The advances in the diagnosis and control of LF have shown promising results, including developing novel diagnostic tools, therapeutic agents, and integrated vector management and surveillance strategies. This review explores the latest advances in our understanding of LF epidemiology, transmission assessments, clinical manifestations, and immune response to infection. We further discuss the current state of diagnostic development, treatment approaches, and control measures, highlighting the importance of continued research in the fight against this disease.
{"title":"Current perspectives in the epidemiology and control of lymphatic filariasis.","authors":"Dziedzom K de Souza, Moses J Bockarie","doi":"10.1128/cmr.00126-23","DOIUrl":"10.1128/cmr.00126-23","url":null,"abstract":"<p><p>SUMMARYLymphatic filariasis (LF), a debilitating tropical disease caused by parasitic filarial worms, <i>Wuchereria bancrofti</i>, <i>Brugia malayi</i>, and <i>Brugia timori</i>, remains a significant public health challenge in tropical and subtropical settings where the disease is endemic. The disease affects millions worldwide, leading to severe disability and social stigma. Following the World Health Assembly resolution WHA50.29 in 1997 encouraging Member States to eliminate LF as a public health problem, the Global Programme to Eliminate Lymphatic Filariasis (GPELF) was established in 2000. The establishment of the GPELF paced the way for global eradication efforts, with commitments from non-governmental organizations and Merck donating the drug ivermectin as long as it is needed to control the disease. The advances in the diagnosis and control of LF have shown promising results, including developing novel diagnostic tools, therapeutic agents, and integrated vector management and surveillance strategies. This review explores the latest advances in our understanding of LF epidemiology, transmission assessments, clinical manifestations, and immune response to infection. We further discuss the current state of diagnostic development, treatment approaches, and control measures, highlighting the importance of continued research in the fight against this disease.</p>","PeriodicalId":10378,"journal":{"name":"Clinical Microbiology Reviews","volume":" ","pages":"e0012623"},"PeriodicalIF":19.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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