Lancet Microbe最新文献

{"title":"Strengthening hepatitis B virus clinical research in Africa: the need for multistakeholder collaboration, funding, and political will","authors":"Mitchell Leus MPH ,&nbsp;Chukwunomso E Osakwe PhD ,&nbsp;Danjuma Adda MPH ,&nbsp;Manal El-Sayed PhD ,&nbsp;Jessica Hicks BComm ,&nbsp;Yasmin Ibrahim PhD ,&nbsp;Philippa C Matthews PhD ,&nbsp;Nicaise Ndembi PhD ,&nbsp;Theobald Owusu-Ansah MS ,&nbsp;Catherine Wendy Spearman PhD ,&nbsp;Mark W Sonderup MMed ,&nbsp;John Ward MD ,&nbsp;Robin Schaefer PhD ,&nbsp;Veronica Miller PhD","doi":"10.1016/j.lanmic.2025.101266","DOIUrl":"10.1016/j.lanmic.2025.101266","url":null,"abstract":"<div><div>Africa bears a disproportionate burden of hepatitis B virus (HBV) infection, with 68 million chronically infected individuals and 65% of global new infections. However, only 18 (1%) of 1804 global HBV clinical trials have been conducted in Africa, limiting the generalisability of therapeutic findings. The HBV arm of the Forum for Collaborative Research convened a series of multistakeholder discussions between 2023 and 2024, to identify gaps in clinical research and identify solutions. This Personal View synthesises insights from these convenings, highlighting key barriers and potential solutions to the disparities in HBV clinical research. Barriers include inadequate funding, insufficient political will, low community awareness, and logistical challenges due to health-care infrastructure and regulatory systems. This Personal View emphasises the urgent need for African-led research, given region-specific factors such as diverse HBV genotypes and co-infections with HIV and hepatitis D virus. We propose solutions, including strengthening regulatory frameworks, leveraging existing research networks, establishing industry funding consortiums, and advocating for increased investment.</div></div>","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101266"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic determinants of antibiotic resistance for Helicobacter pylori treatment: a retrospective phenotypic and genotypic observational study","authors":"Francisco José Martínez-Martínez MSc ,&nbsp;Álvaro Chiner-Oms PhD ,&nbsp;Victoria Furió PhD","doi":"10.1016/j.lanmic.2025.101217","DOIUrl":"10.1016/j.lanmic.2025.101217","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Rising antimicrobial resistance of &lt;em&gt;Helicobacter pylori&lt;/em&gt; is a public health challenge. Genomic-based susceptibility testing allows for the identification of resistance-associated mutations, complementing conventional diagnostics and advancing towards pathogen-based personalised therapies. Our study aimed to identify genes and mutations involved in antimicrobial resistance in &lt;em&gt;H pylori&lt;/em&gt; and evaluate the extent to which these markers can be used as predictors of phenotypic resistance against clarithromycin and levofloxacin.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this retrospective phenotypic and genotypic observational study, we included 1011 &lt;em&gt;H pylori&lt;/em&gt; whole-genome sequences and strains of known geographical origin from the &lt;em&gt;H pylori&lt;/em&gt; Genome Project (&lt;em&gt;Hp&lt;/em&gt;GP) collection. We performed phenotypic clarithromycin and levofloxacin susceptibility testing on a subset of 419 &lt;em&gt;Hp&lt;/em&gt;GP strains using Etest at a centralised laboratory. A genomic analysis was conducted to identify &lt;em&gt;23S rRNA&lt;/em&gt; and &lt;em&gt;gyrA&lt;/em&gt; variants and build a curated catalogue of mutations associated with resistance to clarithromycin (ie, &lt;em&gt;23S rRNA&lt;/em&gt; 2142A→G, 2142A→C, and 2143A→G) and levofloxacin (ie, &lt;em&gt;gyrA&lt;/em&gt; A88V or A88P, N87K or N87I, and D91G, D91N, or D91Y). Genotype–phenotype concordance was assessed to estimate sensitivity and specificity, and the curated catalogue of resistance-associated mutations was applied to the complete &lt;em&gt;Hp&lt;/em&gt;GP set. Region-specific prevalence of resistance-associated mutations was calculated for a combined dataset including the &lt;em&gt;Hp&lt;/em&gt;GP genomes and 768 whole-genome sequences retrieved from the US National Center for Biotechnology Information Sequence Read Archive repository. Associations between resistance genotypes, &lt;em&gt;H pylori&lt;/em&gt; subpopulations, and minimum inhibitory concentrations (MICs) were tested.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Clarithromycin-resistant and levofloxacin-resistant &lt;em&gt;Hp&lt;/em&gt;GP strains were estimated with a sensitivity and specificity of 100%, with all confidence intervals ranging from 96% to 100%. The combined analysis (n=1779) found the highest prevalence of clarithromycin resistance in the western Pacific region (173 [51·2%] of 338 in southeast Asia and 75 [29·8%] of 252 in eastern Asia), north African region (seven [38·9%] of 18), and western Asian region (12 [31·6%] of 38), whereas the highest prevalence of levofloxacin resistance was found in south Asia (14 [51·85%] of 27), Central America (48 [38·7%] of 124), eastern Europe (four [36·4%] of 11), and southern Africa (three [33·3%] of nine). Similarly, &lt;em&gt;23S rRNA&lt;/em&gt; and &lt;em&gt;gyrA&lt;/em&gt; genotypes are variable across &lt;em&gt;H pylori&lt;/em&gt; subpopulations. MIC values changed depending on the specific mutation in &lt;em&gt;23S rRNA&lt;/em&gt; (mean clarithromycin MIC 24·61 mg/L [95% CI 12·27–36·96] for 2143A→G and 142·25 mg/L [95% CI 77·88–206·61] for 2142A→G) and &lt;em&gt;gyrA&lt;/em&gt; (mean levofloxac","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101217"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of repeated mass drug administration on the transmission of yaws: a retrospective genomic epidemiology study","authors":"Amber Barton DPhil ,&nbsp;Petra Pospíšilová PhD ,&nbsp;Camila G Beiras PhD ,&nbsp;Lucy N John MD ,&nbsp;Wendy Houinei MPH ,&nbsp;Prof Lorenzo Giacani PhD ,&nbsp;Prof David Šmajs PhD ,&nbsp;Prof Michael Marks PhD ,&nbsp;Prof Oriol Mitjà PhD ,&nbsp;Mathew A Beale PhD ,&nbsp;Prof Nicholas R Thomson PhD","doi":"10.1016/j.lanmic.2025.101229","DOIUrl":"10.1016/j.lanmic.2025.101229","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Yaws, a neglected tropical disease caused by &lt;em&gt;Treponema pallidum&lt;/em&gt; subspecies &lt;em&gt;pertenue&lt;/em&gt; (&lt;em&gt;T p pertenue&lt;/em&gt;), has evaded eradication, in part due to a high proportion of asymptomatic cases. Repeated mass drug administration (MDA), whereby an entire population is repeatedly treated irrespective of disease, could provide a solution. Here, we aimed to investigate the effect of MDA on the genomic epidemiology of &lt;em&gt;T p pertenue&lt;/em&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective genomic epidemiology study on samples collected during a cluster-randomised trial of mass administration of azithromycin for yaws eradication in the Namatanai District of Papua New Guinea. Participants were in 38 wards (administrative units encompassing several villages) in three local-level government areas (LLGs). The experimental group received an initial round of MDA followed by two further rounds 6 months and 12 months after the first round. The control group received one round of MDA followed by two rounds of treatment targeting clinical cases and contacts only, on the same schedule as the MDA in the experimental group. A follow-up survey on both groups was done 18 months after the first MDA round. Swab samples were collected at each round from ulcerative and nodular skin lesions, and blood was collected by finger-prick for serological testing at 18 months. Metadata on ulcer size (cm) and duration (days) were recorded at each round, and treponemal and non-treponemal antibodies were recorded at 18 months. Samples from swabs positive for &lt;em&gt;T p pertenue&lt;/em&gt; underwent library preparation and whole-genome sequencing. We examined the phylogenetic relationships between genomes, linking them with geospatial and patient metadata to understand the impact of MDA on &lt;em&gt;T p pertenue&lt;/em&gt; diversity and transmission.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Swabs collected from 297 individuals with active yaws from April 30, 2018, to Nov 2, 2019, yielded 222 good-quality &lt;em&gt;T&lt;/em&gt; &lt;em&gt;p pertenue&lt;/em&gt; genomes. We identified 20 sublineages of &lt;em&gt;T p pertenue&lt;/em&gt; in the control group and 21 in the experimental group at the beginning of the study. At the end of the study, there were 13 sublineages in the control group and three in the experimental group, of which two persisted in both groups. Three sublineages not detected at baseline were observed in the control group after commencing MDA. The two sublineages that persisted in both groups had non-synonymous mutations in penicillin-binding proteins. One of these sublineages evolved macrolide resistance in three individuals and was associated with lowered treponemal antibody (p=0·0036) and longer ulcer duration (p=0·015). Despite the study taking place within a small island, sublineages were geographically clustered, with pairs of samples from the same ward (odds ratio 7·1, 95% CI 5·7–8·8; p&lt;0·0001) or neighbouring wards (4·3, 3·3–5·4; p&lt;0·0001) more likely to sha","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101229"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-resistant fungi: the unintended consequence of modern immunosuppression","authors":"Xiaoqing Fan ,&nbsp;Jingyuan Ning","doi":"10.1016/j.lanmic.2025.101225","DOIUrl":"10.1016/j.lanmic.2025.101225","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101225"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why did rabies control fail in low-income and middle-income countries?","authors":"Krishna Prasad Acharya ,&nbsp;Sarita Phuyal ,&nbsp;Richard Trevor Wilson ,&nbsp;Narayan Acharya ,&nbsp;Sher Bahadur Pun ,&nbsp;Kishor Pandey","doi":"10.1016/j.lanmic.2025.101259","DOIUrl":"10.1016/j.lanmic.2025.101259","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101259"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucosal immune responses to Bordetella pertussis in Gambian infants after maternal and primary vaccination: an immunological substudy of a single-centre, randomised, controlled, double-blind, phase 4 trial","authors":"Anja Saso MBBS ,&nbsp;Janeri Fröberg PhD ,&nbsp;Haddijatou Jobe MSc ,&nbsp;Marc Eleveld BSc ,&nbsp;Michael Okoye MSc ,&nbsp;Ebrima Kanteh BSc ,&nbsp;Annemijn Arns BSc ,&nbsp;Fred van Opzeeland BSc ,&nbsp;Michelle Kumado MSc ,&nbsp;Amadou Faal MSc ,&nbsp;Elishia Roberts MSc ,&nbsp;Modou-Lamin Fofana BSc ,&nbsp;Aru-Kumba Baldeh MPH ,&nbsp;Karamo Conteh BSc ,&nbsp;Bram van Cranenbroek BSc ,&nbsp;Sophie Roetynck PhD ,&nbsp;Prof Marien de Jonge PhD ,&nbsp;Prof Thushan I de Silva PhD ,&nbsp;Prof Martijn Huynen PhD ,&nbsp;Prof Beate Kampmann MD PhD ,&nbsp;Dimitri A Diavatopoulos PhD","doi":"10.1016/j.lanmic.2025.101219","DOIUrl":"10.1016/j.lanmic.2025.101219","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Mucosal protection against pertussis depends on antibodies and the activation of mucosal-resident memory T cells, both of which are differentially induced by acellular pertussis and whole-cell pertussis vaccines. We aimed to investigate the effect of primary vaccination with these two vaccine types on pertussis-specific mucosal immunity in infants after their mothers received an acellular pertussis-containing vaccine (tetanus–diphtheria–acellular pertussis–inactivated poliovirus; Tdap–IPV) or a tetanus-toxoid (TT)-only vaccine during pregnancy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This immunological substudy was embedded within the Gambian Pertussis Study (GaPs), a single-centre, randomised, controlled, double-blind, phase 4 trial conducted in The Gambia. In GaPs, healthy, pregnant participants aged 18–40 years were randomly assigned (1:1) to receive a pertussis-containing (Tdap–IPV) vaccine or a TT-only vaccine at 28–34 weeks’ gestation, and their infants were randomly assigned (1:1) to receive a primary immunisation series comprising either a diphtheria–tetanus–whole-cell pertussis (DTwP) vaccine or a diphtheria–tetanus–acellular pertussis (DTaP) vaccine at the ages of 8, 12, and 16 weeks. Nasosorption devices were used to collect nasal mucosal lining fluid (MLF) from infants at the ages of 8, 16, 17, and 20 weeks, and 9 months. The immunological substudy was conducted in a subset of infants in the GaPs trial for whom MLF and paired cord blood and serum samples were available; outcomes were the concentrations of nasal anti-&lt;em&gt;B pertussis&lt;/em&gt; IgG and IgA and anti-pertussis toxin IgG, before and after the DTaP or DTwP primary immunisation series at the ages of 8 weeks, 20 weeks, and 9 months, and the concentrations of nasal T-cell-associated cytokines at age 17 weeks. This study is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT03606096&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;This substudy included 160 infants enrolled in the main GaPs trial between Feb 13, 2019, and May 17, 2021. At age 8 weeks, before primary vaccination, infants born to mothers who had received the Tdap–IPV vaccine in pregnancy had higher concentrations of maternally derived nasal anti-pertussis toxin IgG (geometric mean ratio 3·84 [95% CI 3·22–4·59]; p&lt;0·0001) and anti-&lt;em&gt;B pertussis&lt;/em&gt; IgG (6·45 [5·94–7·01]; p&lt;0·0001), but not IgA, than infants whose mothers received the TT vaccine in pregnancy. After primary vaccination, both groups of infants who received the DTwP vaccine had significantly higher geometric mean concentrations (GMCs) of nasal anti-&lt;em&gt;B pertussis&lt;/em&gt; IgG than infants who received the DTaP vaccine (5·42 arbitrary units [AU] per mL [95% CI 3·79–7·75], p=0·0036 for the TT–DTwP group and 4·40 AU/mL [2·99–6·45], p=0·024 for the Tdap–IPV–DTwP group &lt;em&gt;vs&lt;/em&gt; 2·16 AU/mL [1·40–3·32] for the Tdap–IPV–DTaP group). Furthermore, DTaP-vac","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101219"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbapenemase-producing Citrobacter species in Chinese children, 2015–24: emerging cefiderocol-resistant hypervirulent clones","authors":"Chen Xu ,&nbsp;Lili Huang ,&nbsp;Xiangkun Zeng ,&nbsp;Ruichao Li ,&nbsp;Ning Dong","doi":"10.1016/j.lanmic.2025.101221","DOIUrl":"10.1016/j.lanmic.2025.101221","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101221"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pandemic toolbox for clade 2.3.4.4b A(H5N1) influenza virus risk assessment","authors":"Jessica A Belser","doi":"10.1016/j.lanmic.2025.101240","DOIUrl":"10.1016/j.lanmic.2025.101240","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101240"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SARS-CoV-2 infectious shedding and rebound among adults with and without oral antiviral use: two case-ascertained prospective household studies","authors":"Melisa M Shah MD ,&nbsp;Glen R Abedi MPH ,&nbsp;Scott Lu MBBS ,&nbsp;Miguel Garcia-Knight PhD ,&nbsp;Jesus Pineda-Ramirez BA ,&nbsp;Sarah A Goldberg MAS ,&nbsp;Prof Carlos G Grijalva MD ,&nbsp;Prof H Keipp Talbot MD MPH ,&nbsp;Jonathan Schmitz MD PhD ,&nbsp;Karen Lutrick PhD ,&nbsp;Katherine D Ellingson PhD ,&nbsp;Prof Melissa S Stockwell MD MPH ,&nbsp;Ellen Sano DO ,&nbsp;Huong Q Nguyen PhD ,&nbsp;Suchitra Rao MBBS ,&nbsp;Prof Edwin J Asturias MD ,&nbsp;Mehul S Suthar PhD ,&nbsp;Alexandra M Mellis PhD ,&nbsp;Prof Steven G Deeks MD ,&nbsp;Prof Jeffrey N Martin MD ,&nbsp;Amethyst Zhang","doi":"10.1016/j.lanmic.2025.101227","DOIUrl":"10.1016/j.lanmic.2025.101227","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The effect of COVID-19 oral antivirals on the duration of SARS-CoV-2 infectious viral shedding and viral rebound remains uncertain. This study aimed to examine the association of oral antivirals with viral dynamics, shedding of infectious virus, and SARS-CoV-2 rebound.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A prospective case-ascertained household study design was used. Participants were non-hospitalised adults older than 18 years with symptomatic SARS-CoV-2 enrolled in one of two prospective household transmission studies (University of California, San Francisco, FindCOVID and Respiratory Virus Transmission Network–Sentinel [RVTN–S]) conducted in the USA across six states at academic institutions from Jan 1, 2022 to June 10, 2023. We excluded those reporting receipt of multiple COVID-19 outpatient medications, treatment with remdesivir, a treatment duration of more than 6 days, and those from whom fewer than five daily anterior nasal swabs were collected during their illness. Participants were considered to be at high risk of severe COVID-19 (and, therefore, eligible for SARS-CoV-2 oral antiviral treatment) if they were aged 50 years or older or were aged 18 years or older and reporting at least one underlying condition. Study procedures included frequent self-collected nasal swabs (daily for 14 days after symptom onset and then every 3 days until day 28 after symptom onset in FindCOVID and two nasal swabs daily for 10 days from enrolment in RVTN-S) and viral testing by quantitative reverse transcriptase PCR (qRT-PCR), at-home antigen testing, and viral culture. Treatment was defined as self-reported receipt of an oral antiviral (nirmatrelvir–ritonavir or molnupiravir). The primary analysis compared viral detection by qRT-PCR, antigen test positivity, and culture positivity and assessed SARS-CoV-2 viral rebound (viral RNA, antigen, culture, and symptom rebound) in untreated and treated participants at high risk of severe outcomes. We used multivariable Poisson regression to assess associations between treatment, duration of test positivity, and the presence of viral culture rebound, adjusting for age, underlying conditions, and recent immunological events.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between Jan 1, 2022, and June 10, 2023, 160 individuals with symptomatic COVID-19 and at high risk of severe outcomes were included in FindCOVID and RVTN–S. There was no significant difference in the duration of viral detection between treated and untreated participants at high risk of severe COVID-19 by antigen test positivity (6 days [IQR 5–11] &lt;em&gt;vs&lt;/em&gt; 8 days [5–10]; adjusted relative risk [RR] 1·07, 95% CI 0·24–4·81) or viral culture (7 days [4–11] &lt;em&gt;vs&lt;/em&gt; 6 days [5–9]; 2·21, 0·45–10·79). Among 122 participants without viral RNA rebound, the last day of antigen test positivity and detection of culturable virus post-symptom onset was earlier in treated participants than in untreated participants (5 days [4–8] &lt;em&gt;vs&lt;/em","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101227"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the role of animals in antimicrobial resistance","authors":"Elissa Khamisse ,&nbsp;Xavier Bertrand ,&nbsp;Damien Bouchard ,&nbsp;Lucie Collineau ,&nbsp;Olivier Fortineau ,&nbsp;Marisa Haenni ,&nbsp;Jean-Yves Madec ,&nbsp;Claude Saegerman ,&nbsp;Etienne Giraud ,&nbsp;Eric Oswald","doi":"10.1016/j.lanmic.2025.101248","DOIUrl":"10.1016/j.lanmic.2025.101248","url":null,"abstract":"","PeriodicalId":46633,"journal":{"name":"Lancet Microbe","volume":"7 1","pages":"Article 101248"},"PeriodicalIF":20.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}