bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2026–01–18
thirty-six papers selected by
Luca Bolliger, lxBio



  1. Arthroplasty. 2026 Jan 13. 8(1): 4
       INTRODUCTION: Periprosthetic joint infections (PJI) pose significant clinical challenges due to biofilm formation and antibiotic resistance. Standard treatment often involves implant removal and prolonged antibiotic therapy. Novel strategies target intracellular pathogens and biofilm-associated bacteria, including liposomal antibiotics, antimicrobial peptides, and bacteriophage therapy. Bacteriophages offer specificity and minimal disruption to human microbiota but remain experimental in PJI. Combining phages with targeted antibiotics shows promising results in preclinical models, though further research is needed to confirm efficacy in human PJI and optimise delivery methods.
    OBJECTIVES: This study updates the current evidence on the use of bacteriophages for patients with PJI, proposing guidelines for their clinical application.
    METHOD: PubMed was searched for articles containing phage therapy in revision arthroplasty. No additional filters or time constraints were used. All eligible studies were accessed by hand.
    RESULTS: A total of 39 studies (20 clinical, 19 reviews) on phage therapy for PJI were analysed, covering 56 patients. Of those, negative outcomes were only reported in five. Most studies involved elderly patients with periprosthetic infections of the knee or hip and showed high success rates when combined with antibiotics and surgery. Phage therapy was well tolerated, with only mild adverse effects, such as fever and reversible transaminitis, occurring predominantly with intravenous administration. Review articles reveal that despite promising outcomes, challenges remain, including a lack of standardisation, limited clinical data, and regulatory hurdles.
    CONCLUSION: This study highlights the potential of phage therapy for PJI, emphasising its high specificity, ability to target antibiotic-resistant bacteria, and capacity to disrupt biofilms, and provides a guideline for its clinical administration. Clinical adoption, however, remains limited by regulatory barriers, lack of standardised protocols, and insufficient trial data. Key steps for implementation include establishing regulatory frameworks, developing academic-industrial partnerships and reference centres, and identifying indications supported by controlled trials. With these in place, phage therapy could become a promising adjunct in managing periprosthetic joint infections. Video Abstract.
    Keywords:  Arthroplasty; Musculoskeletal medicine; Periprosthetic joint infection; Phage therapy
    DOI:  https://doi.org/10.1186/s42836-025-00355-6
  2. mSystems. 2026 Jan 16. e0147625
      Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) infection is gradually increasing globally. Phage therapy is a viable application as an alternative to antibiotics. However, clinical application of phage therapy is restricted by phage resistance. To further explore the mechanism underlying phage resistance, particularly the difference observed between in vivo and in vitro, we employed a mouse intra-abdominal infection model to assess the antibacterial properties of two lytic phages and further isolate and characterize phage-resistant mutants. We identified that the majority of the mutation sites in the phage-resistant K. pneumoniae mutants were located in the capsular polysaccharide (CPS) gene cluster, as determined through genomic and transcriptomic analysis. However, some K. pneumoniae phage-resistant mutants, including RM01, RM02, and RM12, developed phage resistance by downregulating CPS and the respective transcriptional regulators without any mutations in the CPS gene. In summary, these findings provide further evidence supporting phage therapy, particularly addressing the issue of CR-hvKP infections.IMPORTANCEThe global rise in antibiotic resistance has rekindled interest in utilizing bacteriophage therapy as a potential solution. In this study, we explored the therapeutic potential of two novel bacteriophages, with a focus on their in vivo efficacy using mouse models, and analyzed the probable mechanisms of phage resistance in bacteria. Our results indicated that in a murine infection model, phages JLBP1001 and JLBP1002 for Klebsiella pneumoniae were highly effective, significantly improving mouse survival. We further characterized and analyzed phage-resistant K. pneumoniae isolated from the mice and found that the resistance mechanisms in an in vivo environment are primarily concentrated in the capsular polysaccharide gene cluster. In RM01, RM02, and RM12, putA contributes to phage resistance through point mutations. These insights are important for optimizing phage-based therapies, particularly in the context of multidrug-resistant bacterial infections.
    Keywords:  Klebsiella pneumoniae; phage resistance; phage therapy
    DOI:  https://doi.org/10.1128/msystems.01476-25
  3. Crit Care. 2026 Jan 13.
       BACKGROUND: Ventilator-associated pneumonia (VAP) caused by multidrug-resistant Klebsiella pneumoniae (MDR-Kp) remains a major clinical challenge in critically ill patients. While bacteriophage therapy shows promise, clinical data on inhaled formulations are limited.
    METHODS: In this prospective, single-center, open-label, non-randomized interventional pilot study, we evaluated the efficacy and safety of a hospital-adapted phage cocktail in patients with MDR-Kp VAP. The cocktail was designed based on retrospective genomic and phenotypic analysis of local isolates. All patients received standard antibiotics and were assigned to three groups (n = 7 each): targeted phage therapy (cocktail active in vitro), non-targeted phage control (cocktail inactive in vitro), or control (no phage). A non-target phage control group was included to evaluate possible non-specific or immunomodulatory effects of phage presence in the respiratory tract. Phages were administered via nebulization twice daily for 14 days. The primary endpoint was microbiological eradication of any K. pneumoniae at day 14; secondary endpoints included clinical response and safety, assessed through clinical and laboratory parameters.
    RESULTS: By day 14, microbiological eradication of K. pneumoniae from respiratory samples was documented in 86% (6/7) of patients receiving targeted phage therapy, compared to 57% (4/7) with antibiotics alone and 0% (0/7) with non-targeted phages. Distinct patterns of infection dynamics were observed, with targeted therapy associated with more rapid and consistent clearance. Co-colonization with other nosocomial pathogens (primarily A. baumannii and S. marcescens) was common but showed no evidence of competitive interference with K. pneumoniae eradication. No significant between-group differences were observed in vital signs or laboratory indices; however, the PT group exhibited a significant within-group improvement in oxygenation (p = 0.0247), alongside earlier de-escalation of ventilatory support and discontinuation of antibiotics. Inhaled phage administration was well tolerated, with no therapy-related adverse events.
    CONCLUSIONS: This comparative pilot study outlines a translational approach from local K. pneumoniae epidemiology to hospital-adapted phage cocktails. Although preliminary, our findings illustrate how this pragmatic approach could be evaluated into intensive care unit workflows, positioning hospital-adapted cocktails as a potential middle ground between broad-spectrum and personalized phage therapy.
    Keywords:  Bacteriophage therapy; Capsular typing; Inhalation therapy; Multidrug-resistant Klebsiella pneumoniae; Ventilator-associated pneumonia
    DOI:  https://doi.org/10.1186/s13054-026-05839-8
  4. Poult Sci. 2026 Jan 09. pii: S0032-5791(26)00046-5. [Epub ahead of print]105(3): 106416
      Non-typhoidal Salmonella species cause 85% of human foodborne cases and infections caused by multidrug-resistant Salmonella strains are increasing. Therefore, alternative antimicrobials are needed, and phage therapy offers a promising tool to reduce the spread of Salmonella in the human food chain. The aim of this study was to determine if a phage cocktail delivered in water could reduce Salmonella shedding in infected egg laying hens, and Salmonella abundance on the surface of eggshells in eggs produced by infected hens. 240 56-week-old layer hens, which were environmentally infected with Salmonella were divided into three treatment groups: T1, no phage cocktail, T2, phage cocktail at dose 3×106 PFU/day and T3, phage cocktail at dose 3×105 PFU/day. The phage cocktail was delivered in their drinking water, for 28 days. Our study found by day 28 the higher phage dose (T2) was more efficient at reducing Salmonella shedding (p<0.01) and median Salmonella shedding counts were 3.10×104 and 0.00 CFU/g for groups T1 and T2 respectively. In the eggs produced by T2 phage treated hens, Salmonella abundance on eggshells was reduced by 60% (p<0.01) compared to the eggs produced by infected hens that received no phage treatment. We showed phage treatment effectively reduced Salmonella transmission in laying hens and in their eggs. Our data highlights that phage treatment is a promising tool to improve food safety.
    Keywords:  Bacteriophages; Novel antimicrobials; Phage therapy; Poultry; Salmonella
    DOI:  https://doi.org/10.1016/j.psj.2026.106416
  5. Clin Biomech (Bristol). 2026 Jan 08. pii: S0268-0033(25)00317-1. [Epub ahead of print]132 106744
       BACKGROUND: Chronic wounds, such as pressure ulcers, venous leg ulcers, and diabetic foot ulcers, present a significant healthcare challenge due to their prolonged healing times and association with biofilm infections. This study introduces a mathematical model to investigate wound healing dynamics during the proliferative stage, focusing on chronic wound conditions characterised by poor vascularisation, clotting deficiencies, cellular senescence, and bacterial biofilms.
    METHODS: The model examines the interactions between fibroblasts, keratinocytes, granulation tissue, nutrients, and signalling molecules under normal and impaired healing scenarios. The potential of bioactive glass fibres, doped with antimicrobial and wound healing ions, is also explored.
    FINDINGS: Model results reflect the impairment of wound healing by biofilm infections, with larger bacterial populations leading to poorer outcomes. Simulations suggest that antimicrobial ions reduce bacterial populations and improve nutrient availability, supporting fibroblast and immune cell activity. Reapplication of bioactive glass fibres enhances ion concentrations, further promoting granulation tissue formation and wound closure under certain conditions.
    INTERPRETATION: Results identify critical parameters that hinder healing in untreated wounds and demonstrate how bioactive glass fibre design can be optimised to enhance healing outcomes. This work provides a foundation for designing cost-effective treatments for chronic wounds, addressing a significant unmet clinical need.
    Keywords:  Bioactive glass fibres; Biofilm infections; Chronic wounds; Mathematical model; Wound healing
    DOI:  https://doi.org/10.1016/j.clinbiomech.2025.106744
  6. Nat Microbiol. 2026 Jan 16.
      Bacteria have evolved sophisticated antiphage systems that halt phage replication upon detecting specific phage triggers. Identifying phage triggers is crucial to our understanding of immune signalling; however, they are challenging to predict. Here we used a plasmid library that expressed over 400 phage protein-coding genes from 6 phages to identify triggers of known and undiscovered antiphage systems. We transformed our library into 39 diverse strains of E. coli. Each strain natively harbours a different suite of antiphage systems whose activation typically inhibits growth. By tracking plasmids that were selectively depleted, we identified over 100 candidate phage trigger-E. coli pairs. Two phage proteins were further investigated, revealing that T7 gp17 and additional tail fibre proteins activated the undescribed antiphage system PD-T2-1 and identifying that λ gpE major capsid protein activated the antiphage system Avs8. These experiments provide a unique dataset for the continued definition of the molecular mechanisms underlying the bacterial immune system.
    DOI:  https://doi.org/10.1038/s41564-025-02239-6
  7. J Wound Ostomy Continence Nurs. 2026 Jan-Feb 01;53(1):53(1): 13-19
      One constant in the care of patients with wounds and multiple chronic illnesses is the use of pharmacotherapy. While clinicians understand the need for drug use to treat patients' disorders, some may not be aware of their potential impact on wound healing. This article describes wound healing processes, explains how common categories of drugs exert both detrimental and helpful effects on wound healing, and delineates clinical implications for health care providers. Alternative topical use of prescription medications and complementary (herbal) therapy is also described.
    Keywords:  Drugs; Medications; Pharmacologic therapy; Wound healing
    DOI:  https://doi.org/10.1097/WON.0000000000001247
  8. J Wound Ostomy Continence Nurs. 2026 Jan-Feb 01;53(1):53(1): 55-58
      Providing foot and wound care to psychologically challenged homeless persons presents complex psychosocial and medical challenges. Homeless individuals often suffer from both physical and psychological comorbidities that are compounded by their living conditions. In this article, I explore the psycho-dynamics of delivering foot and related wound care to homeless persons with psychological challenges. Challenges related to delivering care to this vulnerable population include psycho-social dynamics/interaction, accommodating the emotional and behavioral challenges in delivering care, trauma-informed factors, and the relational impacts on both patients and providers. Best clinical practices for creating a safe and supportive space for both practitioner and patient are outlined, drawing from existing literature and evidence-based care models.
    Keywords:  Behavior; Food and wound care; Homeless; Psychosocial dynamics; Relationship
    DOI:  https://doi.org/10.1097/WON.0000000000001244
  9. Wound Repair Regen. 2026 Jan-Feb;34(1):34(1): e70121
      Chronic non-healing wounds represent a major clinical challenge, often associated with diabetes, vascular insufficiencies and aging. Despite the substantial burden that such wounds place on patients and healthcare systems, few biomarkers have been approved for prediction of wound healing trajectories and outcomes, limiting opportunities to inform clinical management decisions or quantify patient responses to interventions. Recent advances have identified cell-free nucleic acids as powerful tools for gaining molecular insights because they offer a non-invasive, dynamic snapshot of physiological and pathological processes occurring throughout the body. In particular, cell-free RNAs from non-coding RNA families including microRNA, long non-coding RNA, circular RNA and transfer RNA fragments can be profiled on a large scale to reveal novel disease signatures to support biomarker development. The presence of such non-coding RNAs in serum, plasma or other biofluids provides a rich resource for uncovering new parameters that can support biomarker development for wound repair. In this review article, we highlight some of the current challenges associated with biomarkers for wound healing in clinical practice. We then survey the microRNAs, long non-coding RNA and circular RNAs landscape in relation to their utility as biomarkers in diabetic foot ulcers and other chronic wounds. Collectively, these extracellular RNAs offer a multifaceted view of wound biology and may serve as non-invasive biomarkers for stratifying wound severity, predicting healing outcomes and guiding personalised interventions.
    Keywords:  cell‐free RNA; circular RNA; diabetic foot ulcers; exosomes; extracellular vesicles; long non‐coding RNA; microRNA; skin; wound healing
    DOI:  https://doi.org/10.1111/wrr.70121
  10. Arch Microbiol. 2026 Jan 12. 208(2): 115
      The rise of multidrug-resistant (MDR) bacteria, especially the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp.), is one of the most significant issues in modern medicine. Berberine, a quaternary ammonium isoquinoline alkaloid derived from a number of plant species, has been shown to be an effective therapeutic agent against resistant pathogens. This review provides a detailed overview of the chemical structure, pharmacology, and mechanism of action for berberine against ESKAPE and other MDR bacteria. The literature suggests that berberine displays antimicrobial activity through several mechanisms, including damaging the membrane, inhibiting DNA gyrase, inhibiting protein synthesis, and inhibiting efflux pumps. Berberine shows considerable synergy when combined with standard antibiotics, which could reverse antibiotic resistance. Notably, berberine demonstrates synergistic effects with β-lactam antibiotics, reducing fractional inhibitory concentration (FIC) indices to 0.25-0.5, thereby enhancing antibacterial efficacy against multidrug-resistant strains. Although berberine exhibits remarkable in vitro antimicrobial activity, its very poor systemic bioavailability (< 1%) results in a more than 1000-fold PK-PD gap between achievable plasma levels and effective MIC values. The clinical and preclinical studies show a good safety profile for use with minimal toxicity at therapeutic concentrations. Therefore, the current clinical use of berberine is limited to adjuvant, topical, or gastrointestinal applications rather than systemic monotherapy. The routes of delivery, pharmacokinetic characteristics, and standardization of treatment remain obstacles for wider application. This review collates the current evidence that supports berberine as an alternative or adjunct therapy to combat the worldwide issue of antibiotic resistance and also indicates areas where further research is required to bring therapies to the clinical level.
    Keywords:  Alkaloid therapeutics; Antimicrobial activity; Berberine; ESKAPE pathogens; Multidrug resistance; Synergistic effects
    DOI:  https://doi.org/10.1007/s00203-025-04663-y
  11. J Virol. 2026 Jan 16. e0195025
      In the post-antibiotic era, bacteriophages have emerged as viable alternatives for combating antibiotic-resistant infections. Analogous to the emergence of antibiotic resistance, bacteria can also develop resistance to phages, a process often accompanied by a reduction in bacterial fitness. In this study, we investigated the mechanisms behind the development of phage resistance in Salmonella enterica serovar Enteritidis strain WJ48 during laboratory coevolution with phage GRNsp8, as well as the associated fitness costs and community dynamics. Three types of phage-resistant mutants, VP81, VP82, and VP84, were isolated. VP81 exhibited a frameshift mutation in the gene encoding glycosyltransferase and displayed partial resistance to GRNsp8. Both VP82 and VP84 carried frameshift mutations in btuB, conferring complete resistance to GRNsp8. Deletion of btuB abolished phage adsorption and conferred complete resistance. Meanwhile, complementation with btuB restored susceptibility. In vitro competition assays showed that the btuB-deletion strain was competitively disadvantaged relative to the wild-type strain within 24 h, exhibiting a relative fitness value of <1. Consistently, in vivo experiments in mice showed a marked attenuation of virulence in the mutant strain. Specifically, the LD₅₀ of the btuB-deficient strain in mice was 6.8 × 10⁸ CFU, 121 times higher than the wild-type strain. During the 9-day coevolution experiment, a single-point mutation in btuB consistently dominated and represented the primary mode of resistance. These findings shed light on the adaptive trade-offs that bacteria undergo to evade phage infection and provide valuable insights for designing more rational and effective phage therapy strategies that exploit these trade-offs.IMPORTANCEAs emerging antibacterial agents in the post-antibiotic era, Bacteriophages also face the challenge of bacterial resistance. However, phage resistance development by bacteria is frequently accompanied by a reduction in bacterial fitness. To elucidate the adaptive trade-offs associated with resistance, in this study, we used Salmonella enterica serovar Enteritidis strain WJ48 and the broad-host-range bacteriophage GRNsp8 as a model system. We found that the acquisition of phage resistance by bacteria was significantly associated with a reduction in virulence. These findings deepen our understanding of bacteria-phage coevolution but also offer key insights into leveraging the resistance-fitness trade-off to inform the strategic design of more effective phage therapies. The results highlight the potential for improving the application of phages in agriculture and animal husbandry, supporting the sustainable development of phage-based antimicrobial strategies.
    Keywords:  Salmonella Enteritidis; bacterial fitness; bacteriophage resistance; evolutionary dynamics
    DOI:  https://doi.org/10.1128/jvi.01950-25
  12. Tissue Eng Regen Med. 2026 Jan 10.
       BACKGROUND: Bacteriophage mixtures have been explored as biomaterials to promote tissue repair. In this study, we tested the hypothesis that incorporating a phage mixture into a wound dressing could modulate immune cell responses and skin cell migration within the wound environment.
    METHODS: Phage strains specific to three common bacterial pathogens-Escherichia coli, Salmonella enterica, and Pseudomonas aeruginosa-were embedded in an alginate hydrogel (E-Alg) or grafted onto its surface (S-Alg). The viability of the phages released from the samples were tested. 3T3 fibroblasts in a transwell system were co-cultured with Raw 264.7 macrophages seeded on the dressing samples containing the phage mixture. The cytokine release and fibroblast migration through the transwell membrane were measured.
    RESULTS: The phages remained lytic to their hosts after incorporation in the dressing samples (p < 0.001). Macrophages internalized similar numbers of phages, regardless of whether they were stimulated with lipopolysaccharide (LPS) or not (p > 0.05). In the presence of the phage mixture, the resting macrophage produced significantly more nitric oxide (NO), interleukin 1ß (IL-1ß) and tumor necrosis factor α (TNF-α) (p < 0.001). In contrast, the phage mixture significantly reduced the production of these inflammatory mediators in LPS-stimulated macrophages (p < 0.001). The numbers of fibroblast migrating through the membrane toward the macrophages positively correlated with the concentrations of TNF-α and IL-10 released by the macrophages.
    CONCLUSION: A nonhealing wound-common in diabetic patients-is often a result of weakened immune responses. A phage-releasing dressing may not only alleviate bacterial infection but also attract and stimulate immune responses that promote skin repair.
    Keywords:  Bacteriophage cocktail; Fibroblast migration; Inflammatory modulation; Macrophage; Wound dressing
    DOI:  https://doi.org/10.1007/s13770-025-00786-x
  13. J Wound Care. 2026 Jan 02. 35(1): 48-58
      Cutaneous wound healing consists of complex processes involving different types of cells and signalling pathways, and occurs in three phases (inflammatory, proliferative and tissue remodelling). The dysregulation of these processes leads to abnormal wound healing, manifesting as hard-to-heal (chronic) wounds at one extreme and pathological scarring at the other. Recent studies have shown that the tumour necrosis factor-like weak inducer of apoptosis (TWEAK)/fibroblast growth factor-inducible 14 (Fn14) signalling pathway regulates inflammatory, re-epithelialisation, collagen synthesis and angiogenesis processes, suggesting that it can modulate cutaneous wound healing. Despite numerous studies suggesting a relationship between the TWEAK/Fn14 axis and cutaneous wound healing, there has been little attention paid to this relationship to date. There is scarce direct evidence supporting that TWEAK/Fn14 axis-targeted therapies work in cutaneous wounds. This review summarises the evidence that TWEAK/Fn14 signalling is involved in wound repair as well as in tissue remodelling. In addition, TWEAK/Fn14 axis-targeted therapies in other diseases are highlighted, and their therapeutic potential in cutaneous wounds discussed.
    Keywords:  Fn14; TWEAK; healing; inflammation; skin wound; wound; wound care; wound dressing; wound healing
    DOI:  https://doi.org/10.12968/jowc.2023.0091
  14. Biotechnol Adv. 2026 Jan 14. pii: S0734-9750(26)00010-8. [Epub ahead of print] 108804
      Bacteriophage(phage)-based interventions have been considered for environmental and biomedical applications as well as during food processing, representing a promising alternative when multidrug-resistant bacteria are found. Although liquid and semi-solid formulations are easier to prepare as few unit operations are required, stability issues or short-term effects have led to the prioritization of solid formulations. Polymeric films have gained prominence as a strict control of phage release or improved phage stability can be achieved. During film preparation, phages are deposited onto a pre-ready solid support or incorporated in a film-forming solution. Advantages and disadvantages of each preparation method as well as the impact of different processing conditions (temperature, pH, ionic strength and agitation) on phage viability/stability are discussed in detail in this review. High viral titer broadens the spectrum of materials and film preparation methods that can be considered. The orientation of some phages during immobilization into solid supports, in turn, has proven to be a key aspect for phage infectivity, particularly for tailed phages. The points raised in this review are certainly an important direction for future technological developments in this field, contributing to the development of films with longer-lasting action.
    Keywords:  Film preparation methods; Phages; Polymeric films
    DOI:  https://doi.org/10.1016/j.biotechadv.2026.108804
  15. ACS Nano. 2026 Jan 15.
      Oral nanomedicines provide a promising, noninvasive drug delivery platform, offering advantages in patient compliance and ease of administration. However, their clinical translation for both gastrointestinal (GI) and extra-GI diseases is hampered by multiple physiological and pharmacokinetic barriers, including the harsh GI environment, poor translocation across the mucus and epithelial layers, rapid hepatic and renal clearance, limited tissue accumulation, inefficient cellular uptake, insufficient lysosome escape, and suboptimal intracellular drug release. These challenges collectively result in low oral bioavailability and limited therapeutic outcomes. This review provides a comprehensive overview of recent advances in oral nanomedicines, delineating six key attributes for effective GI-targeted drug delivery and eight design principles for systemic applications. We also discuss the translational bottlenecks and highlight the emerging strategies to overcome these barriers, offering insights into the integration of oral nanotherapeutics into precision medicine.
    Keywords:  delivery barrier; design principle; gastrointestinal disease; non-gastrointestinal disease; oral nanomedicine
    DOI:  https://doi.org/10.1021/acsnano.5c14045
  16. J Med Microbiol. 2026 Jan;75(1):
      Introduction. Chronic wounds are notoriously difficult to treat and are associated with decreased limb function, reduced quality of life and significant morbidity. Their recurrent nature, despite aggressive antibiotic therapy, is due in part to the presence of polymicrobial biofilms. Pseudomonas aeruginosa and Staphylococcus aureus are two of the most frequently co-isolated pathogens in these infections and are known to form complex biofilms that hinder treatment.Hypothesis. We hypothesized that co-existence and competitive dynamics between P. aeruginosa and S. aureus in chronic wound infections are influenced by strain-specific interactions and may not rely solely on well-characterized inhibitory mechanisms such as 2-alkyl-4-quinolone (AQ) production by P. aeruginosa impacting on S. aureus fitness.Aim. To establish a polymicrobial chronic wound infection model and assess the contribution of AQ signalling and strain-specific interactions on co-existence.Methodology. We used a modified chronic wound biofilm model to co-culture matched and mismatched clinical isolate pairs of P. aeruginosa and S. aureus, collected from two different chronic wound patients. Viable bacterial counts (c.f.u.) were quantified over an 8-day period. AQ production by each P. aeruginosa strain was quantified using liquid chromatography-MS.Results. A stable culture of P. aeruginosa strains was achieved, but distinct behaviours between each S. aureus strain were seen. One matched clinical isolate pair maintained stable c.f.u. levels of both species throughout the 8-day model, indicating a compatible co-existence. In contrast, mismatched pairs showed early loss of S. aureus viability and the emergence of small colony variants after 4 days, not seen in matched pair growth. Interestingly, the most competitive P. aeruginosa strain exhibited undetectable levels of all AQs tested, indicating that its dominance was not due to AQ-mediated antagonism, as has previously been described.Conclusion. Our findings demonstrate that stable dual-species biofilm formation in chronic wounds is strain-dependent and that P. aeruginosa can impact on S. aureus fitness through AQ-independent mechanisms. These results highlight the importance of using clinical isolates in biofilm research and caution against generalizing findings from laboratory strains to complex clinical infections.
    Keywords:  2-alkyl-4-quinolone molecules; P. aeruginosa; S. aureus; biofilm; chronic wound; clinical isolates
    DOI:  https://doi.org/10.1099/jmm.0.002118
  17. Regen Ther. 2026 Mar;31 101053
       Objective: To summarize the best evidence for platelet-rich plasma therapy in chronic wounds, providing an evidence-based foundation for standardizing its clinical practice.
    Methods: Guided by the "6S" evidence pyramid model, we systematically searched 12 databases including Cochrane Library and Pubmed, 9 guideline websites including Guidelines International Network (GIN) and National Institute for Health and Clinical Excellence (NICE), and 10 professional websites including World Union of Wound Healing Societies (WUWHS), for relevant evidence from the establishment of the database to May 1, 2025. Two researchers independently conducted quality assessment, evidence extraction, and integration of the included literature.
    Results: A total of 17 articles were included, comprising 3 guidelines, 5 expert consensus statements, and 9 systematic reviews. The evidence was categorized into six key treatment domains: application principles, indications and contraindications, pre-treatment preparations, treatment protocols, efficacy monitoring, and management strategies. 27 individual recommendations were derived from these categories.
    Conclusion: Platelet-rich plasma therapy can be used as an adjunctive treatment for the management of chronic wounds. Clinicians and wound care specialists should thoroughly assess the applicability and timing of platelet-rich plasma, considering the specific clinical context, and combine it with the patient's physical condition and preferences for clinical application, promoting chronic wound healing and reducing the global disease burden of chronic wounds.
    Keywords:  Chronic wounds; Evidence summary; Evidence-based nursing; Platelet-rich plasma
    DOI:  https://doi.org/10.1016/j.reth.2025.101053
  18. Cell Discov. 2026 Jan 14. 12(1): 4
      Mammalian wound healing is orchestrated by tightly regulated cellular and molecular programs across the hemostasis, inflammation, proliferation, and remodeling phases. Here, we propose the concept of spatiotemporal clocks as a unifying framework for understanding how transitions between phases are coordinated. We dissect the roles of distinct spatial domains: epidermis, dermis, fascia, wound edges, and wound center, and highlight the oscillatory molecular signals that govern their dynamic interactions. Special attention is given to wound-induced hair neogenesis (WIHN) as a model of regenerative potential. By integrating spatial and temporal dimensions, this framework unifies the multidimensional aspects of wound healing, laying a robust foundation for the development of innovative therapeutic strategies.
    DOI:  https://doi.org/10.1038/s41421-025-00865-2
  19. Gut Microbes. 2026 Dec 31. 18(1): 2612836
      Enteric infections remain a leading global cause of morbidity, mortality and economic loss, increasingly compounded by the rise of antimicrobial resistance. The gut microbiome - spanning bacteria, archaea, fungi, protists and viruses - is now recognized as an important mediator that shapes susceptibility to infection, pathogen expansion and disease severity through mechanisms such as colonization resistance, resource competition and immune modulation. Conversely, the gut microbial community can facilitate enteric infection through other processes such as cross-feeding and horizontal gene transfer. In this review, we synthesize correlative and mechanistic evidence currently available on microbiome-pathogen interactions; outline host, environmental and socioeconomic modifiers that affect disease risk across the life course; and evaluate current clinical applications. We highlight key limitations in the field and identify priority areas for future research to refine causal models of microbiome-pathogen ecology and enable targeted diagnostics and therapeutics for preventing and managing enteric infections.
    Keywords:  Enteric infection; antibiotics; colonization resistance; horizontal gene transfer; microbiome; pathogens
    DOI:  https://doi.org/10.1080/19490976.2026.2612836
  20. Acta Haematol. 2026 Jan 12. 1-14
       BACKGROUND: Chronic graft-versus-host disease (cGVHD) remains a major cause of late morbidity and non-relapse mortality following allogeneic hematopoietic cell transplantation. Early identification and intervention are critical to improving outcomes. Corticosteroids continue to serve as the first-line therapy; however, treatment-refractory cases are common and associated with poor outcomes. Ruxolitinib has become the standard second-line agent, yet beyond Ruxolitinib, treatment selection varies widely due to a lack of comparative data and standardized sequencing strategies.
    METHODS: A comprehensive review of key therapeutic trials in chronic GVHD was conducted, with a focus on second-line treatments and beyond. Emerging and investigational therapies were also included through analysis of recent literature and ongoing studies.
    RESULTS: There is currently no established sequencing of agents beyond second-line therapies. The approval of belumosudil, axatilimab, and ibrutinib has expanded therapeutic options, with each agent offering a unique mechanism of action and demonstrating promising, organ-specific response rates.
    CONCLUSION: The therapeutic landscape for chronic GVHD is evolving, with several newer agents beginning to demonstrate utility in third-line settings. However, the selection of third-line agents remains largely dependent on clinical judgment, prior treatment history, and the specific organs involved. There is a continuing and critical need for well-designed, comparative trials to establish optimal treatment strategies.
    DOI:  https://doi.org/10.1159/000550265
  21. J Pharm Bioallied Sci. 2025 Dec;17(Suppl 4): S3214-S3216
       Background: Sutures are essential for wound closure but may facilitate microbial colonization, increasing the risk of surgical site infections. Antibacterial-coated sutures, such as triclosan (TCS) and chlorhexidine (CCS), have been developed to mitigate this concern.
    Materials and Methods: A double-blind, randomized clinical trial was conducted on 20 patients undergoing periodontal flap surgery, comparing TCS and CCS. Healing was assessed on postoperative day 8 using Landry's Healing Index; microbial burden was quantified through CFU enumeration and Gram staining.
    Results: Healing scores were comparable between groups (TCS: 4.1 ± 0.7; CCS: 3.9 ± 0.7; P = 0.63). However, CCS exhibited significantly lower CFU counts (0.011 × 106 ± 0.031 × 106) than TCS (4.3 × 106 ± 4.8 × 106) (P < 0.001). Gram staining revealed polymicrobial oral flora in both groups.
    Conclusion: Chlorhexidine-coated sutures exhibited superior antimicrobial efficacy without compromising early wound healing.
    Keywords:  Antibacterial sutures; chlorhexidine-coated sutures; chronic periodontitis; flap surgery; triclosan-coated sutures
    DOI:  https://doi.org/10.4103/jpbs.jpbs_1288_25
  22. Int J Low Extrem Wounds. 2026 Jan 16. 15347346251413947
      Diabetic foot ulcers (DFUs) are a serious complication of diabetes, associated with high risks of infection, amputation, and reduced quality of life. Silver nanoparticle dressings, known for their broad-spectrum antimicrobial and anti-inflammatory properties, offer a promising advanced treatment option. This prospective, randomized, single-blind controlled trial evaluated the efficacy of tetra silver tetroxide dressings compared to conventional dressings in managing DFUs, with limb salvage as the primary endpoint and wound healing parameters as secondary endpoints. Fifty-nine patients were randomly assigned to Group A (tetra silver tetroxide spray and gel, n = 30) or Group B (conventional dressings, n = 29). While no statistically significant difference in limb salvage rates was observed (Group A: 100% vs 86.21%; P = .052), the silver nanoparticle dressing demonstrated superior outcomes in all secondary endpoints: a higher rate of complete healing (100% vs 82.76%, P = .024), reduced mean healing time (9.77 vs 18.79 weeks, P < .001), lower incidence of post-treatment infection (0% vs 20.69%, P = .011), and fewer median dressing days (62.5 vs 122.5 days, P < .001). These findings indicate that tetra silver tetroxide nanoparticle dressings significantly accelerate wound healing, reduce infection, and lessen treatment burden, supporting their use as an effective DFU treatment option.
    Keywords:  diabetic foot ulcer; silver nanoparticles; tetra silver tetroxide; wound dressing < wound management; wound healing
    DOI:  https://doi.org/10.1177/15347346251413947
  23. J Cyst Fibros. 2026 Jan 14. pii: S1569-1993(25)02553-6. [Epub ahead of print]
       BACKGROUND: The 22-item sinonasal outcome test (SNOT-22) is widely used to evaluate quality of life (QOL) in cystic fibrosis chronic rhinosinusitis (CF-CRS) but lacks formal validation in people with CF (PwCF). This study explores the psychometric properties of the SNOT-22 following elexacaftor/tezacaftor/ivacaftor (ETI) administration.
    METHODS: Data from three prospective observational cohort studies investigating the impact of ETI on CF-CRS were pooled across four U.S. centers and used for validity assessments. SNOT-22 scores, Lund-Mackay (LM) computed tomography (CT) sinus scores, and Cystic Fibrosis Questionnaire-Revised (CFQ-R) scores were used to assess test-retest reliability, construct validity, and responsiveness to clinical change in SNOT-22 scores.
    RESULTS: Strong test-retest reliability was observed for the SNOT-22 during the first 6 months post-ETI (N = 53, all r ≥ 0.80, p < 0.001). SNOT-22 intraclass correlation coefficients were strong (0.883) at 3 and 6 months after ETI was initiated and moderate (0.693) across all time points. Mean individual scores in 20 SNOT-22 items decreased from baseline to post-ETI (90.1%, p < 0.05). Moderate convergent validity was observed between pre-treatment SNOT-22 scores and LM scores (r = -0.42, p = 0.002) and CFQ-R respiratory domain scores (r = -0.35, p = 0.025).
    CONCLUSIONS: The SNOT-22 is a valid, reliable, and responsive instrument for evaluating CRS-specific QOL in adults with CF, and functions effectively as a unidimensional construct across most of its 22 items.
    Keywords:  Chronic rhinosinusitis; Cystic fibrosis; Elexacaftor/tezacaftor/ivacaftor; Highly effective modulator therapy
    DOI:  https://doi.org/10.1016/j.jcf.2025.12.022
  24. Caries Res. 2026 Jan 15. 1-23
       BACKGROUND: Advances in next-generation sequencing(NGS) and multi-omics approaches reinforced the concept of functional diversity within biofilm communities, revealing roles beyond bacterial taxonomy and highlighting metabolic and ecological mechanisms operating at the individual level rather than within isolated caries lesions. Moving toward new clinical solutions will require broader perspectives; to this end, we propose key directions to advance the translational potential of caries microbiome research. We present a perspective that connects ecological theory, molecular evidence, and clinical implications through three central topics: (I)microbial composition, (II)microbial function, and (III)individual-level characteristics.
    SUMMARY: From a compositional perspective, caries microbiome research should move beyond the search for bacterial culprits and instead consider the broader microbial ecosystem, including low-abundance and non-bacterial members (such as archaea). Within this framework, microbial taxa and functions should not be viewed as inherently "good" or "bad," but rather as context-dependent components of a dynamic ecosystem shaped by sustained environmental pressures. Functionally, the recurrent enrichment of pathways related to carbohydrate metabolism, sugar transport, and acid production likely reflects microbial adaptation to persistent sugar exposure rather than intrinsic virulence traits. This perspective suggests that progress in caries research depends on moving beyond disease-centered models toward understanding how microbial stability preserves oral health. At the individual level, individuals with previous caries experience may retain disease-associated microbial or functional signatures during remission, a phenomenon referred to here as a microbiological dysbiosis scar. This ecological memory may help explain why past caries experience remains one of the strongest predictors of future lesions and highlights the importance of incorporating individual history into the design and interpretation of caries microbiome studies. Integrating detailed clinical metadata with advanced bioinformatic approaches, including artificial intelligence, will be essential for establishing meaningful biological links.
    KEY MESSAGES: Progress in caries microbiome research depends on refining study design across microbial composition, functional, and individual levels. Strengthening the resilience of the oral microbiome rather than eliminating specific pathogens or the microbiome should be the central goal of caries microbiology. Moving from blame to balance is not merely semantic; it represents a fundamental shift in how we study, prevent, and manage dental caries.
    DOI:  https://doi.org/10.1159/000550472
  25. Int J Low Extrem Wounds. 2026 Jan 13. 15347346251413943
      BackgroundDiabetic foot ulcers (DFUs) are a serious complication of diabetes, often leading to amputations and high healthcare costs. Dipeptidyl peptidase-4 (DPP-4) inhibitors may help wound healing by enhancing angiogenesis. This study aimed to evaluate the efficacy of DPP-4 inhibitors in DFUs healing.MethodsThis systematic review and meta-analysis followed PRISMA 2020 guidelines. Randomized controlled trials (RCTs) comparing DPP-4 inhibitors with standard care or placebo were searched in PubMed, Scopus, Web of Science, and Cochrane Library up to October 1, 2025. Relative risk (RR) and mean difference (MD) were pooled using a random-effect model.ResultsFour RCTs with 285 patients were included. DPP-4 inhibitors significantly increased complete ulcer healing (RR = 1.63, 95% CI 1.30-2.06, P < .0001) and shortened healing time (MD = -10.72 days, 95% CI -14.61 to -6.84, P < .00001). Ulcer size was also reduced (MD = -2.36 cm2, 95% CI -2.95 to -1.77, P < .00001). Side effects were rare and similar between groups.ConclusionTreatment with DPP-4 inhibitors improves DFU healing outcomes compared to the control group. This finding is limited to the number of included studies and the small sample size. Future randomized clinical trials are warranted to provide more robust results.
    Keywords:  DPP-4 inhibitors; diabetes mellitus; diabetic foot ulcer; wound healing
    DOI:  https://doi.org/10.1177/15347346251413943
  26. J Colloid Interface Sci. 2026 Jan 11. pii: S0021-9797(26)00033-0. [Epub ahead of print]708 139856
      Diabetic wound management remains a major clinical challenge due to the difficulty in achieving precise therapeutic modulation and the lack of reliable approaches for real-time identification of wound pathological stages. To address this, we report the development of a novel covalent organic frameworks@metal-organic frameworks theranostic nanoreactor, namely glucose oxidase (GOx)-encapsulated zeolitic imidazolate framework-8 (ZIF-8) assembled on the surface of fluorescent hollow covalent organic frameworks (denoted as HCOF@FZG) through a one-pot coordination strategy. The nanoreactor is designed to concurrently monitor wound pH fluctuations and provide synergistic treatment for diabetic wounds. Leveraging pH-triggered fluorescence changes, HCOF@FZG enables non-invasive, dynamic assessment of wound conditions, allowing for precise discrimination between the healing and infection stages. Upon detecting signs of infection, HCOF@FZG initiates a cascade reaction in which GOx-mediated oxidation depletes local glucose for starvation therapy, while the generated H2O2 is subsequently converted into bactericidal hydroxyl radicals via a Fenton-like reaction for chemodynamic therapy. Moreover, HCOF@FZG demonstrates remarkable pro-healing properties by significantly promoting endothelial cell proliferation and migration. This acceleration of granulation tissue formation and re-epithelialization critically improves overall wound recovery, offering an intelligent and precise solution for managing diabetic chronic wounds.
    Keywords:  Cascade reactions; Nanoreactor; Synergistic therapeutic; Wound healing
    DOI:  https://doi.org/10.1016/j.jcis.2026.139856
  27. NPJ Biofilms Microbiomes. 2026 Jan 16.
      Implant-associated infections caused by biofilm-forming bacteria, such as Staphylococcus aureus, remain a major clinical challenge due to their high tolerance to conventional antibiotic therapies. We report a dual-targeted therapeutic strategy that combines a tri-enzymatic cocktail designed to degrade key components of the biofilm matrix (TEC; comprising a DNA/RNA endonuclease, an endo-1,4-β-D-glucanase, and a β-N-acetylhexosaminidase), with vancomycin, both delivered via a thermosensitive poloxamer 407 hydrogel, for localized treatment of S. aureus biofilms. The formulation was evaluated both in vitro, on titanium-adherent biofilms, and in vivo, using a model of tissue cages containing titanium beads implanted in the back of guinea pigs. Animals additionally received intraperitoneal administration of vancomycin alone or combined with rifampicin. In vitro, this formulation enabled sequential drug release, with TEC delivered within the first 24 h and vancomycin for up to 96 h, and achieved >5 Log₁₀ reductions in CFU counts after two applications at 48 h interval. In vivo, biofilm-associated bacterial counts reached the detection limit (100 CFU; >5 Log10 decrease from the initial inoculum) in 75% of implants 1 day post-treatment and remained undetectable in 37.5% of them 5 days post-treatment, with no emergence of resistance. Treatment efficacy was reduced if TEC or vancomycin were omitted in the hydrogel or if rifampicin was not included in the intraperitoneal treatment. Vancomycin in the hydrogel also prevented the emergence of rifampicin resistance. These findings underscore the therapeutic potential of a dual-targeted approach, combining biofilm disruption with local sustained antibiotic release, to improve the management of implant-associated infections.
    DOI:  https://doi.org/10.1038/s41522-026-00910-2
  28. J Nanobiotechnology. 2026 Jan 17.
      Extracellular vesicles (EVs) are emerging as naturally bioactive nanomaterials with intrinsic biocompatibility and targeting potential. Recent integration of machine learning (ML) into EV research has accelerated advances in molecular profiling, structure-function prediction, and rational design of vesicle-based therapeutics. Yet, the inherent complexity and heterogeneity of EV populations pose major analytical challenges. Concurrently, machine learning is revolutionizing biomedical science by uncovering patterns in high dimensional, multimodal datasets. In EV research, ML has enabled major advances across automated imaging, multi omics integration, disease classification, therapeutic engineering, and standardization. This review presents a comprehensive synthesis of ML-enabled EV studies, organized by data modality (imaging, omics, cytometry), algorithmic paradigm (CNNs, random forests, autoencoders, GNNs), and translational application (diagnosis, prognosis, drug delivery, manufacturing QC). Unlike prior reviews that have typically considered EV biology and AI methods in relative isolation, we introduce a unified three-axis taxonomy that explicitly links EV data modalities, machine learning architectures, and clinical use-cases, thereby providing a structured map of the field. We discuss key technical barriers including data sparsity, batch variability, and model explainability and spotlight frontier developments such as federated learning, self-supervised models, and real-time EV analytics. At the nexus of computational intelligence and nanomedicine, ML-enhanced EV platforms are rapidly progressing from fragmented innovations to clinically actionable systems. This review offers a roadmap for advancing AI-integrated EV technologies in cancer precision medicine.
    Keywords:  AI driven materials design; Bioinspired nanomaterials; Extracellular vesicles (EVs); Machine learning in nanomedicine; Smart nanotherapeutics; Targeted drug delivery platforms
    DOI:  https://doi.org/10.1186/s12951-025-03952-4
  29. Arch Virol. 2026 Jan 11. 171(2): 51
      Multidrug-resistant Klebsiella pneumoniae requires alternative therapies. In this study, we characterized two novel phages, PKP K9 (a siphovirus) and PKP Kh11 (a myovirus). Both showed genomic safety and exhibited excellent reproduction and physicochemical tolerance. A cocktail containing both phages had a broad combined host range (85.7%, 72/84) and showed potent in vitro activity with distinct dose-dependent inhibition modes. In a Galleria mellonella infection model, each phage individually and the two combined provided complete prophylactic and therapeutic protection against lethal challenge. The PKP K9/PKP Kh11 cocktail demonstrates significant therapeutic potential against multidrug-resistant K. pneumoniae.
    Keywords:  Bacteriophage cocktail; Galleria mellonella; Klebsiella pneumoniae; antibacterial activity; biocontrol
    DOI:  https://doi.org/10.1007/s00705-026-06521-8
  30. ACS Biomater Sci Eng. 2026 Jan 16.
      Bacterial infection, excessive inflammation, and oxidative stress pose significant challenges to the wound healing process. Multifunctional hydrogels, as wound dressings, hold promising potential to overcome the current obstacles in wound treatment. In this study, three metal ions (copper, zinc, and calcium, CZC) were mixed with sodium alginate (SA) to form a slowly cross-linked network, followed by the incorporation of glycyrrhizic acid (GA) to establish a CZC-SA-GA dual-network hydrogel. Copper ions exhibit antibacterial and angiogenic properties. Zinc ions synergistically enhance antibacterial efficacy and provide antioxidant effects. Calcium ions promote structural cross-linking and facilitate cell migration. The introduction of GA significantly enhances the mechanical strength of the hydrogel (compressive modulus increased by approximately 67%) and endows it with anti-inflammatory activity. The CZC-SA-GA hydrogel demonstrates excellent cytocompatibility, promotes cell migration and angiogenesis (VEGF is significantly upregulated), and exhibits potent anti-inflammatory (reduces the expression levels of NO, IL-6, and iNOS) and antioxidant effects (reduces MDA activity and ROS accumulation and increases T-GSH level). Additionally, it shows broad-spectrum antibacterial activity against both Gram-positive and Gram-negative bacteria (bactericidal efficacy ≈100%). In a murine full-thickness skin wound model, the application of the CZC-SA-GA hydrogel accelerated wound healing (wound closure accelerated by ∼20%). The development of natural drug-based hydrogels with integrated antibacterial, anti-inflammatory, and antioxidant properties presents a promising strategy for treating severe skin wounds.
    Keywords:  glycyrrhizic acid; hydrogel; metal ions; sodium alginate; wound healing
    DOI:  https://doi.org/10.1021/acsbiomaterials.5c01424
  31. PeerJ. 2026 ;14 e20624
       Objective: The aim of this study was to evaluate the effectiveness of WeChat-based remote care guidance as a supplement to standard care for patients with diabetic foot ulcers. Our specific objectives were to compare healing rates, self-management behaviors, and patient satisfaction between the two groups, with a focus on identifying patient subgroups that might benefit most from this approach.
    Methods: A retrospective cohort study was conducted at Fujian Maternity and Child Health Hospital between June 2021 and December 2022, with follow-up until December 2024. Among 131 eligible patients with diabetic foot ulcers (Wagner grades 1-4), 59 received WeChat -based guidance (intervention) while 72 received standard care (control). Primary outcomes included wound healing rate and time-to-healing. Quality of life (WHOQOL-BREF) and treatment satisfaction (DTSQs) were assessed at baseline, 3, 6, 12, and 24 months. Analyses were adjusted for demographic characteristics, clinical parameters, and disease severity indicators.
    Results: The intervention group showed significantly higher healing rates (88.1% vs 63.9%, P = 0.001) and faster healing time (HR = 2.27, 95% CI [1.35-3.82], P = 0.002). The effect was particularly pronounced in Wagner grade 2-3 ulcers (HR = 14.3-34.2, P < 0.001) and patients receiving interventional procedures (HR = 3.4, 95% CI [1.8-6.3], P <0.001). At 24 months, the intervention group demonstrated greater improvements in quality of life (mean difference = 7.87, P < 0.001) and treatment satisfaction (mean difference = 6.70, P < 0.001).
    Conclusion: WeChat-based remote care guidance was associated with better diabetic foot ulcer healing outcomes, particularly for moderate-severity ulcers and patients undergoing interventional procedures. Our findings also suggest associations between this approach and improvements in quality of life and treatment satisfaction.
    Keywords:  Diabetic foot ulcer; Mobile health; Remote care; Wound healing
    DOI:  https://doi.org/10.7717/peerj.20624
  32. J Pharm Bioallied Sci. 2025 Dec;17(Suppl 4): S3039-S3041
       Background: Urinary tract infections (UTIs) are some of the most usual causes of bacterial infections for pregnant women. They often result from bacteria, known as uropathogens, whose resistance to antibiotics is not constant.
    Materials and Methods: In all, we collected 300 samples of midstream urine from pregnant women at the antenatal clinic because their symptoms were suggestive of a UTI. Samples were first cultured on cystine lactose electrolyte deficient (CLED) and MacConkey agar, and biochemical tests were used to identify uropathogens. Kirby-Bauer disk diffusion was used, according to CLSI standards, to determine which antibiotics were effective against the pathogen. Analysis of the data used descriptive statistics.
    Results: From a collection of 300 urine samples, significant growth from bacteria was seen in 114 cases (38%). Almost half of the uropathogenic bacteria (52.6%) found were Escherichia coli, followed by Klebsiella pneumoniae (21.1%), Enterococcus faecalis (13.2%), and a lesser prevalence of Proteus mirabilis (7.9%). Resistance was found in about three-quarters of isolates to ampicillin and co-trimoxazole, but most isolates were still sensitive to nitrofurantoin and fosfomycin. Resistance to different antibiotics was found in 47.3% of the isolates, more commonly in E. coli strains.
    Conclusion: It was shown in the study that a large number of pregnant women with UTIs are infected by bacteria resistant to many commonly used drugs.
    Keywords:  Antibiotic resistance; E. coli; multidrug resistance; nitrofurantoin; pregnant women; tertiary care hospital; urinary tract infection; uropathogens
    DOI:  https://doi.org/10.4103/jpbs.jpbs_995_25
  33. Nat Commun. 2026 Jan 13.
      Urinary catheters, the most frequently placed medical devices in the US, increase the risk of developing symptomatic catheter-associated urinary tract infection (CAUTI) and asymptomatic bacteriuria (ASB) - the presence of bacteria in the urine - with those requiring long-term urinary catheters (LTUCs) at highest risk. While ASB and CAUTI are caused by a broad range of uropathogens, most remain understudied. We use whole-genome sequencing to investigate the understudied uropathogen, Staphylococcus aureus. Analysis of 153 longitudinal S. aureus isolates previously collected from urinary catheter or urine samples from 20 individuals with LTUCs (average of 8 longitudinal isolates/person) demonstrates that most strains are multidrug resistant (MDR), including methicillin-resistant S. aureus (MRSA), and sequence type 5. Importantly, the same S. aureus strain persisted as ASB for an average of 13 weeks, despite antibiotic exposures or urinary catheter exchanges, and in one case transitioned to symptomatic CAUTI. The longitudinal strains are highly genetically related with few genomic changes and stable antimicrobial resistance and virulence gene carriage. This work demonstrates that MDR S. aureus can persist as ASB long-term and that common strategies to reduce or eliminate microbes from LTUCs were ineffective at eradicating the uropathogen in most cases, despite phenotypic susceptibility to the administered antibiotic.
    DOI:  https://doi.org/10.1038/s41467-025-68081-w
  34. Wound Repair Regen. 2026 Jan-Feb;34(1):34(1): e70125
      Hypergranulation in chronic wounds reflects impaired healing, leading to delayed recovery, increased risk of infection and higher treatment costs for healthcare systems. Despite its impact, hypergranulation is often misidentified in the early stages, hindering timely intervention. This study presents a deep learning-based method to distinguish between hypergranulated and non-hypergranulated tissue. The dataset comprised 6235 wound images from Hospital de la Santa Creu de Vic (Catalonia, Spain) and DFUC 2022, with balanced classes. Five architectures were evaluated using transfer learning: ViT, VGG16, RepVGG, MobileViT and RepGhost. RepGhost achieved the best results (81.4% accuracy, 89.4% area under the receiver operating characteristic curve [AUC]), outperforming both CNNs and transformers. Lightweight models (RepGhost, MobileViT) also demonstrated high performance, making them suitable for implementation on mobile devices. This tool may assist clinicians in the early detection of hypergranulation and improve wound treatment outcomes. This appears to be the first deep learning study on this condition to utilise a large, balanced dataset.
    Keywords:  artificial intelligence; general dermatology; hypergranulation tissue; wound diagnosis
    DOI:  https://doi.org/10.1111/wrr.70125
  35. Food Res Int. 2026 Feb 28. pii: S0963-9969(25)02454-8. [Epub ahead of print]226 118114
      Bacteriophages are promising antibacterial agents across the farm-to-fork continuum. Oral phage efficacy against infections, however, is limited by poor digestion tolerance. To enhance oral phage delivery, we synthesized T4 phage-chitosan conjugates and self-assembled them with phospholipids into protective nanoemulsions. We evaluated chitosan concentration effects on grafting efficiency, phage viability in simulated gastrointestinal (GI) conditions, and antibacterial activity. Nanoemulsions with moderate chitosan concentrations (50-100 μg/mL) optimally protected phages during gastric transit, rescuing ∼5 log10 PFU/mL viability versus free phages. Higher concentrations impaired phage viability and release, while lower concentrations provided inadequate assembly. The optimized formulation (Phage-CL-50) showed superior efficacy against invasive bacteria and biofilms in intestinal epithelia, enabling recoverable transepithelial transport. In mice, Phage-CL-50 significantly enhanced GI phage retention and antibacterial performance. This nanoemulsion strategy offers a rational approach for developing robust oral phage formulations in food industry applications through targeted formulation optimization.
    Keywords:  Antibacterial; Bacteriophage; Chitosan; Digestion tolerance; Nanoemulsion; Oral delivery system
    DOI:  https://doi.org/10.1016/j.foodres.2025.118114
  36. Chin Med. 2026 Jan 14. 21(1): 37
      Bronchiectasis is a complex and heterogeneous disease with various etiologies and clinical manifestations. While Western medicine (WM) primarily focuses on infection control, symptom management, and airway clearance techniques, traditional Chinese medicine (TCM) adopts a holistic strategy aimed at systemic regulation and immune modulation through herbal formulae and acupuncture. The integration of TCM and WM offers a comprehensive therapeutic framework that targets both clinical manifestations and the underlying pathophysiology. This review systematically outlines current WM treatment strategies, such as antibiotic therapy, anti-inflammatory drugs, and surgical interventions. The TCM treatment principles, including individualized syndrome differentiation and treatment, specific TCM formulae, and acupuncture therapies, are detailed. This study further synthesizes clinical evidence demonstrating that integrated TCM-WM therapy not only significantly alleviates symptoms and improves lung function but also enhances immune regulation and quality of life. This combined strategy not only improves clinical outcomes but also enhances patients' quality of life, which provides a more personalized and multidimensional paradigm to manage bronchiectasis. Future research should focus on optimizing integrated protocols, rigorous randomized controlled trials, and exploring novel therapeutic targets to consolidate the evidence base for this synergistic model.
    Keywords:  Bronchiectasis; Integrated treatment; Personalized treatment; Traditional Chinese medicine; Western medicine
    DOI:  https://doi.org/10.1186/s13020-026-01324-0