Infectious Disease Frontier

A recent study published in BMJ Thorax highlights significant changes in the landscape of pneumococcal pneumonia among adults hospitalized with community-acquired pneumonia (CAP) over the past decade. The data, drawn from a prospective cohort of over 5,000 patients, reveals that the proportion of CAP cases caused by pneumococcus has nearly doubled, rising from 36.4% in 2013 to 66.9% in 2023. Notably, serotype 3 has become the dominant strain, increasing from 13.4% to 48.8% during the same period.

Antimicrobial resistance remains one of the biggest threats to global health. A recent study published in Clinical Microbiology and Infection evaluates the in vitro activity of cefepime-enmetazobactam, a novel β-lactam/β-lactamase inhibitor combination, against carbapenem-resistant Gram-negative pathogens.

In the world of inpatient infectious disease (ID) consults, a recurring challenge surfaces: the hesitation to shift from IV to oral antibiotics, even when clinical evidence supports it. This dialogue between an ID consultant and a surgeon, as shared by Dr. Paul Sax in NEJM Journal Watch, perfectly illustrates the tension.

Valuable researchers have conducted a groundbreaking three-arm, open-label, cluster-randomised trial in Niger to evaluate the effectiveness of mass campaigns using full and fractional doses of the pneumococcal conjugate vaccine (Pneumosil, PCV10) in reducing nasopharyngeal pneumococcal carriage among children aged 1–9 years.

Valuable researchers have uncovered promising insights into combating Clostridioides difficile infection (CDI), a leading cause of healthcare-associated infections. The study reveals that a naturally avirulent C. difficile strain, ST1-75, can protect against CDI by outcompeting virulent strains such as R20291.

A recent analysis sheds light on the clinical and mycological outcomes of treating candidaemia and invasive candidiasis with rezafungin compared to caspofungin. This study, pooling data from the STRIVE and ReSTORE trials, evaluated the efficacy of once-weekly rezafungin versus daily caspofungin across various Candida species. The findings suggest that rezafungin offers comparable, and in some cases superior, efficacy, particularly against Candida glabrata and Candida parapsilosis. Moreover, rezafungin demonstrated strong mycological eradication rates and lower all-cause mortality rates in specific Candida infections, positioning it as a promising treatment option.

A recent pragmatic, multicenter randomized controlled trial (BATCH) conducted across 15 hospitals in the UK has provided critical insights into the effectiveness of procalcitonin-guided algorithms in managing antibiotic treatment for children hospitalized with confirmed or suspected bacterial infections.

A recent study by valuable researchers sheds light on the complex immune response in older adults hospitalized with community-acquired pneumonia (CAP) and sepsis. Their research reveals that although these patients exhibit impaired neutrophil functions, such as reduced migratory accuracy and respiratory burst, their glycolytic metabolism remains preserved. This finding challenges the assumption that metabolic dysfunction drives neutrophil impairment in CAP. Interestingly, while basal glycolysis rates were unchanged compared to age-matched controls, they were significantly higher than in healthy young adults, suggesting an age-related metabolic shift.

The origin and evolution of SARS-CoV-2 continue to be topics of intense scientific discussion. A recent comprehensive review by Dr. Edward Holmes sheds light on the virus's emergence, emphasizing a natural zoonotic origin closely linked to the Huanan Seafood Wholesale Market in Wuhan. The study dismisses direct links to laboratory activities, focusing instead on the role of wildlife trade and the complex human-animal interface in driving virus transmission.

The long-term effects of prenatal exposure to SARS-CoV-2 and mRNA COVID-19 vaccines have been a subject of great interest. A new prospective cohort study from the COVI-PREG registry has provided essential insights. The study assessed 330 infants at 12 months of age, comparing those exposed in utero to SARS-CoV-2 or the COVID-19 vaccine with unexposed infants. Using the Ages and Stages Questionnaire (ASQ-3) to evaluate neurodevelopmental outcomes across five domains—communication, gross motor, fine motor, problem-solving, and personal-social development—the findings were reassuring.