bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2026–06–14
fifty-two papers selected by
Luca Bolliger, lxBio
  1. Bacteriophage therapy for multidrug-resistant bacterial infections: recent advances, clinical evidence, and translational challenges.
  2. A guide to the ecological limitations of phage therapy of bacterial biofilms: Is what's best for the phage best for the physician?
  3. Bacteriophages in the treatment of cutaneous infections and skin disorders: therapeutic advances and future directions.
  4. Surveys on Phage Therapy: Current Understanding and Practical Implications.
  5. Phage-essential oil synergy as an evolutionary and biophysical strategy against antimicrobial resistance.
  6. Genome sequences of four virulent Klebsiella pneumoniae phages targeting multidrug-resistant clinical isolates from Ethiopia.
  7. Periodontal Ecosystem and Clinical Implications of the Oral Microbiome: A Narrative Review.
  8. DNA modifications of Durham Collection phages and promiscuity of GmrSD-family Type IV restriction enzyme BrxU.
  9. Bacteriophage therapy for multidrug-resistant pediatric infections: a re-emerging precision antimicrobial strategy.
  10. Bridging the airway microbiome and targeted therapy in bronchiectasis: multi-omics insights, endotypes and emerging therapies.
  11. Artificial intelligence in optimizing antimicrobial therapy for gastro-renal disorders.
  12. Healing beyond the wound: social determinants in chronic vascular care. Perspectives from clinical practice.
  13. Calciphylaxis complicated by NDM-1-producing Pseudomonas aeruginosa: first experience with cefepime-zidebactam alongside phage therapy in the USA.
  14. Treating an unresponsive diabetic foot ulcer with cold atmospheric plasma, maggot therapy and alginate dressing: a case report.
  15. Decoding phage communication: molecular networks, evolutionary dynamics, and therapeutic applications.
  16. Giving Antibiotics a Second Chance: Evolutionary Trade-Offs and Phage-Driven Restoration of Antibiotic Susceptibility.
  17. AI is taking on antibiotic resistance - here's how.
  18. Teaching methods in wound care in nursing education: A scoping review.
  19. Biofilm-mediated antibiotic tolerance in bacterial pathogens: Integrated molecular networks and novel therapeutic avenues.
  20. The skin microbiome: the overlooked axis in modern dermatology.
  21. Virulence Factors of Porphyromonas gingivalis in Periodontitis and Rheumatoid Arthritis: Clinical Implications.
  22. The role of miR-155 and IL-6 in the shared pathogenesis of periodontitis and rheumatoid arthritis: a cross-sectional case-control study.
  23. Periodontitis and Rheumatoid Arthritis-Mechanistic Evidence.
  24. Multifunctional Bioengineered Scaffolds and Adjunct Therapeutic Strategies for Diabetic Foot Ulcers.
  25. A mechanistic framework linking the oral microbiome to Alzheimer's disease through neuroinflammation.
  26. From dysbiosis to precision medicine: targeting the microbial-metabolic axis in IBD management.
  27. Exploring the causal relationship between inflammatory cytokines and diabetic foot ulcer: A bidirectional Mendelian randomization and clinical validation study.
  28. Characterization and Clinical Implications of Multidrug-Resistant Klebsiella pneumoniae in ICU Patients in India: A Comprehensive Review.
  29. Risk factors for the emergence of multidrug-resistant bacteria in patients with head and neck infections: a retrospective analysis.
  30. Artificial Intelligence for Antimicrobial Resistance Detection and Prediction in Klebsiella pneumoniae: A Systematic Review of Clinical Microbiology Applications.
  31. Antibody display technologies from phages to cells: translational bottlenecks and AI-enabled opportunities.
  32. Exploring nurses' experiences of the presence of a wound care specialist: a qualitative study.
  33. Isolation and characterization of a lytic phage targeting carbapenem-resistant Pseudomonas aeruginosa.
  34. Artificial intelligence in pediatric intensive care units: current applications in sepsis management.
  35. Cholecystitis and Liver Abscess Caused by Oral Bacteria.
  36. The European respiratory society guideline for adult bronchiectasis 2025: summary and implementation guide for primary care.
  37. Digital platforms and shared decision-making tools for home wound care: An integrative review.
  38. Phylogenetic Profiling of the Diabetic Foot Ulcer Microbiome of an Afro-Caribbean Population.
  39. Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Dysfunction in Human Diseases: Molecular Mechanisms and Pathophysiological Implications.
  40. Site-specialization of human oral Porphyromonas species.
  41. Diabetes and Delayed Wound Healing: Molecular Mechanisms and Dermatological Interventions.
  42. Epidemiology, antimicrobial resistance patterns, management, and predictors of mortality in diabetic foot infections in a Lebanese hospital: A retrospective observational study.
  43. Personalized dentistry: Enhancing outcomes through patient-centered innovation.
  44. Computational tools for personalizing treatment of acute respiratory failure, from machine learning to digital twins: a narrative review.
  45. High Adherence to Remote Monitoring Technology in Patients at Risk for Diabetic Foot Ulcer.
  46. International guideline on antimicrobial stewardship and the role of microbial-binding dressings in wound care 2026: infection prevention, control, early intervention and treatment.
  47. Artificial Intelligence in Burn and Wound Care: Image Analysis, Prediction, and Clinical Integration.
  48. Unravelling the developmental origins of cystic fibrosis-related diabetes.
  49. Infections in Burn Patients: Pathophysiology, Prevention, and Contemporary Therapeutic Strategies in the Era of Antimicrobial Resistance.
  50. A Systematic Review and Quality Assessment of Clinical Practice Guidelines for Otitis Externa to Support the WHO Package of Ear and Hearing Care Interventions.
  51. Multispecies biofilms are hubs for metabolic interactions leading to ecologically and biotechnologically relevant emergent properties.
  52. Mycobacterium abscessus infection in a young man with cystic fibrosis: a case report and literature review.
  1. Arch Microbiol. 2026 Jun 12. pii: 435. [Epub ahead of print]208(9):
    Bacteriophage therapy for multidrug-resistant bacterial infections: recent advances, clinical evidence, and translational challenges.
    Sushama Agarwalla.
      The increasing prevalence of multidrug-resistant (MDR) bacterial infections has substantially limited the effectiveness of existing antibiotics and highlights the need for alternative therapeutic strategies. Bacteriophage therapy has re-emerged as a potential option, largely due to its ability to selectively target bacterial pathogens, replicate at sites of infection, and disrupt biofilms. This review examines the key mechanisms underlying phage-mediated bacterial killing, including receptor-specific infection, lytic replication, and the action of phage-derived enzymes such as endolysins and depolymerases. Current clinical evidence, largely derived from compassionate-use cases and small case series rather than well-controlled randomized trials, suggests that phage therapy can be beneficial in selected patients with infections caused by organisms such as Pseudomonas aeruginosa, Acinetobacter baumannii, and Staphylococcus aureus, particularly when conventional treatments have failed. The potential advantages of combining phages with antibiotics are also discussed, although the extent and consistency of this synergy remain uncertain. Despite growing interest, the clinical development of phage therapy remains limited by several factors, including narrow host specificity, the emergence of phage resistance, host immune responses that lead to rapid phage clearance and the formation of neutralizing antibodies, heterogeneity in study designs, and the absence of standardized production and regulatory frameworks. Importantly, robust randomized controlled trials are still scarce, making it difficult to draw firm conclusions about efficacy. While recent advances in genomics and phage engineering are likely to support future progress, a clear gap remains between experimental promise and routine, standardized clinical application.
    Keywords:  Antimicrobial resistance; Bacteriophages; Biofilms; Clinical infections; Multidrug-resistant bacteria; Phage therapy; Phage-antibiotic synergy
    DOI:  https://doi.org/10.1007/s00203-026-04980-w
  2. FEBS J. 2026 Jun 08.
    A guide to the ecological limitations of phage therapy of bacterial biofilms: Is what's best for the phage best for the physician?
    Stephen T Abedon.
      Bacterial biofilms-structured communities of bacteria encased in self-produced polymeric matrices-present formidable challenges in clinical medicine. The resistance of biofilms to conventional antibiotics stems from multiple factors. These include limited drug penetration and the presence of metabolically dormant bacteria that survive treatments, despite their retaining sensitivity under standard laboratory conditions. Bacteriophages (phages), the viruses that infect and kill bacteria, have emerged as promising alternatives or adjuncts to antibiotic therapy, including against bacterial biofilms. Phages, nonetheless, likely evolved to optimize especially their dissemination between spatially separated bacteria, including spatially separated biofilms, rather than to become specialists at eradicating all targeted bacteria from biofilms. By contrast, complete bacterial elimination from the body is the standard goal of antibacterial therapies. Considered here is how an understanding of these competing goals-virion dissemination vs. complete bacterial eradication-can inform our development of phage-based anti-biofilm therapies.
    Keywords:  antimicrobial resistance; bacteriophage therapy; biofilm; burst size; extracellular polymeric substance; latent period
    DOI:  https://doi.org/10.1111/febs.70615
  3. Clin Microbiol Rev. 2026 Jun 10. e0004826
    Bacteriophages in the treatment of cutaneous infections and skin disorders: therapeutic advances and future directions.
    Emilia Hauza, Ivy J Mutai, Agnieszka Necel, Deus Kamya, Paulina Śliwka, Izabela Dusza, Alicja Węgrzyn, Aneta Skaradzińska.
      SUMMARYSkin and soft tissue infections represent a major clinical challenge. This is particularly true given the rise in antimicrobial resistance, the increasing prevalence of chronic wounds, and the growing number of immunocompromised patients. Conventional antibiotic therapies are frequently compromised by multidrug-resistant pathogens, biofilm formation, and disruption of the skin microbiome, underscoring the urgent need for alternative or adjunctive antibacterial strategies. Bacteriophages, viruses that specifically infect and lyse bacteria, have re-emerged as promising therapeutic agents due to their high specificity, activity against antibiotic-resistant strains, and capacity to target biofilm-associated infections. This review provides a comprehensive overview of current advances in bacteriophage-based approaches for the treatment of cutaneous infections and skin disorders. We discuss the biological principles of phage therapy, its advantages and limitations, and the regulatory and manufacturing challenges associated with clinical translation. Particular emphasis is placed on topical and biomaterial-based phage delivery platforms, including hydrogels, nanocarriers, and adhesive wound dressings, designed to enhance phage stability, local bioavailability, and therapeutic efficacy. Furthermore, we summarize experimental and clinical evidence supporting the use of bacteriophages against the most clinically relevant skin pathogens. By integrating data from in vitro studies, animal models, clinical trials, and compassionate-use cases, this review highlights both the therapeutic potential and current limitations of phage-based interventions in dermatology. Collectively, the available evidence supports the use of bacteriophages as a viable component of future precision antimicrobial therapies for skin infections, while emphasizing the need for well-designed clinical trials, standardized production protocols, and optimized delivery systems to enable broader clinical adoption.
    Keywords:  antibiotic resistance; bacteriophage therapy; bacteriophages; chronic wounds; melanoma; skin and soft tissue infections (SSTIs)
    DOI:  https://doi.org/10.1128/cmr.00048-26
  4. Int J Antimicrob Agents. 2026 Jun 11. pii: S0924-8579(26)00167-6. [Epub ahead of print] 107880
    Surveys on Phage Therapy: Current Understanding and Practical Implications.
    Maciej Żaczek, Andrzej Górski, Beata Weber-Dąbrowska, Marzanna Łusiak-Szelachowska, Aneta Skaradzińska, Ryszard Międzybrodzki.
      With the ongoing progress of phage therapy, an increasing number of researchers globally undertakes surveys-particularly among physicians-to assess awareness, knowledge, and willingness to incorporate phage treatment into routine clinical practice. Recent surveys from countries such as Australia, Korea, Poland, UK, the US, and two surveys conducted internationally revealed a consistent and clear message that awareness of phage therapy is growing, and the clinical urgency to include it as a means of combatting antibiotic resistance is real. At the same time, the scientific and medical community faces well-known obstacles, and progress in resolving them has been relatively slow. Regulatory uncertainties, scarce number of centers conducting phage therapy, and limited support, especially from the pharma industry are just a few examples. Another important ambiguity is that robust evidence from randomized clinical trials remains limited. In this review article we try to solve the puzzle whether awareness and knowledge about this form of treatment are keeping up with its scientific progress and whether the patient and medical communities are ready for its potential expansion beyond the framework of compassionate therapies with limited availability. One could argue that the ongoing research focusing on phage therapy surveys shares similarities with clinical development of phage treatment as both activities are characterized by multidirectional approaches, varying methodology, lack of coordination, and results that are open to multiple interpretations.
    Keywords:  antibiotic resistance; clinician attitudes; phage therapy; public perception; surveys
    DOI:  https://doi.org/10.1016/j.ijantimicag.2026.107880
  5. Drug Resist Updat. 2026 Jun 05. pii: S1368-7646(26)00082-8. [Epub ahead of print]88 101431
    Phage-essential oil synergy as an evolutionary and biophysical strategy against antimicrobial resistance.
    D X Romero-Calle, F Gordillo Altamirano, C A Carrasco Villanueva.
      The persistent challenge of global antimicrobial resistance means we can no longer rely solely on traditional small-molecule monotherapy. While bacteriophage therapy offers surgical precision, its clinical reach is often limited by biofilm-mediated protection, as well as the rapid evolution of resistance, and stability issues. At the same time, essential oils (EOs) show promising antibacterial activity, yet their clinical use remains stalled due to toxicity and volatility concerns. In this review, we summarize key biomedical concepts underpinning phage therapy and EOs and propose a shift in perspective: reframing EOs as biophysical adjuvants designed to reshape phage-bacteria interactions rather than treating them as standalone antimicrobials. We explore how EO-driven membrane disruption can prime bacteria for phage predation, enhancing phage adsorption and potentially steering populations toward more susceptible phenotypes. Moving beyond simple mixtures, we evaluate the mechanistic evidence for phage-EO synergy. We highlight the early stage of this field: current evidence is limited to in vitro studies, with a lack of preclinical and clinical validation, and significant barriers to clinical translation. However, by treating phage-EO combinations as rationally engineered systems, our review aims to map out a strategic path toward their responsible and meaningful development in the fight against resistant infections.
    Keywords:  Antimicrobial adjuvants; Antimicrobial resistance; Bacteriophage therapy; Biofilms; Essential oils; Evolutionary trade-offs; Translational microbiology
    DOI:  https://doi.org/10.1016/j.drup.2026.101431
  6. Microbiol Resour Announc. 2026 Jun 11. e0121325
    Genome sequences of four virulent Klebsiella pneumoniae phages targeting multidrug-resistant clinical isolates from Ethiopia.
    Assefa Asnakew Abebe, Molalegne Bitew, Alemayehu Godana Birhanu, Dawit Hailu Alemayehu, Abaysew Ayele, Keyru Tuki, Yimer Demssie, Lanchisl Tsegaye Mulualem, Tesfaye Sisay Tessema.
      We present genome sequences of four lytic bacteriophages targeting multidrug-resistant (MDR) Klebsiella pneumoniae isolates. The bacteriophages belong to the genera Taipeivirus, Drulisvirus, Przondovirus, and Webervirus. These phages exhibit promising lytic activity against MDR K. pneumoniae clinical isolates. The genomes of the bacteriophages ranged in size from 15,773 to 166,437 bp.
    Keywords:  Klebsiella pneumoniae; genome analysis; multidrug-resistant; phage therapy
    DOI:  https://doi.org/10.1128/mra.01213-25
  7. Int J Dent. 2026 ;2026 1479982
    Periodontal Ecosystem and Clinical Implications of the Oral Microbiome: A Narrative Review.
    Ana Júlia Martins Targino, Josy Lorena Peres da Silva Vilarinho, Valéria Martins de Araújo Carneiro, Bruna Frizon Greggianin, Maria do Carmo Machado Guimarães.
       Background: Periodontal disease, although widely documented, remains one of the leading causes of tooth loss worldwide. This situation can be attributed to patients' difficulty in following treatment protocols and to an incomplete understanding of the disease's mechanisms, which could be explored to develop new therapies.
    Objective: The present study aimed to summarize the main advances in understanding the periodontal microbiome, especially concerning the development of genetic sequencing technologies and metabolite analysis, as well as new treatment methods that have emerged from these innovations.
    Methods: A narrative literature review was conducted through searches in the PubMed, Scopus, Web of Science, and SciELO databases, prioritizing publications from the past 15 years while also including classic and foundational studies relevant to the theoretical framework.
    Conclusions: Periodontal microbiome results from the synergistic interaction among different microorganisms, rather than just the sum of their individual metabolites. This synergy can create structural microarrangements that resist biofilm disruption, such as fungal barriers surrounding Gram-negative bacteria. Innovative treatments-such as host response modulation with resolvins and oral microbiome modulation, particularly using prebiotics derived from plant extracts (nitrate metabolism)-offer promising prospects. However, limitations remain regarding their clinical use and the challenge of managing refractory cases, highlighting the need for further research to support these findings.
    Keywords:  dysbiosis; host microbial interactions; microbiome; microbiota; periodontitis
    DOI:  https://doi.org/10.1155/ijod/1479982
  8. Appl Environ Microbiol. 2026 Jun 12. e0081026
    DNA modifications of Durham Collection phages and promiscuity of GmrSD-family Type IV restriction enzyme BrxU.
    Jennifer J Readshaw, Abigail Kelly, Yan-Jiun Lee, Giuseppina Mariano, Liam P Shaw, Peter R Weigele, Tim R Blower.
      Bacteriophages (phages), viral predators of bacteria, are an attractive way to combat the rise of antimicrobial resistance. By infecting and killing bacteria, phages generate selection pressure for the evolution of defense systems. Successfully applying phages in the clinic will, in part, depend on understanding and predicting how bacterial defense systems determine the outcomes of a phage infection. Here, we present morphological, genomic, phylogenetic, and modification-based characterization of 12 new bacteriophage species targeting Escherichia coli, isolated from water sources in Durham, UK, during undergraduate practical classes. These phages, added to our growing "Durham Collection," were all determined to be sensitive to the GmrSD-family Type IV restriction enzyme, BrxU. As such, these phages have modified genomic DNAs. HPLC and MS analysis of the genomic DNAs identified a range of modifications present in the Tequatrovirus, Krischvirus, and Mosigvirus phages, the latter of which contained 5-arabinosyl-2'-deoxycytidine (5-ara-dC) and disaccharide arabinobiose (5-ara-ara-dC) moieties. Curiously, Krischvirus phages were shown to have modification pathways distinct from those of Tequatrovirus phages. Finally, testing the modified genomic DNAs in in vitro cleavage assays with BrxU demonstrated cleavage of all modifications tested. This further extends the broad substrate specificity previously identified for BrxU. Collectively, these data provide a larger standardized Durham Collection to be used for better prediction of phage-host interactions and infection outcomes.IMPORTANCEWidespread antibiotic use has led to rising rates of antibiotic resistance. It is estimated that deaths from antibiotic-resistant bacterial infections will outpace deaths from cancer by 2050. Alternate methods of treatment are required. Bacteriophages (phages), are viruses that specifically target bacteria and are predominantly harmless to humans. There is increased interest in using phage therapy in clinics to treat infections. Studying interactions between bacteria and phages is necessary so that we can understand and better predict the outcomes of phage therapy. This will increase the chances of clinical success. Our presented work provides detailed characterization of a set of phages isolated from the environment that infect Escherichia coli, a common pathogen and model experimental system. Standardized collections of phages are time-consuming to generate and the results from our ongoing characterization of the Durham Collection presented here represent a community resource for the ease of comparison between these and other phages strains, as well as across different experimental systems.
    Keywords:  DNA modification; Durham; GmrSD; bacteriophage; phage defense; restriction enzyme
    DOI:  https://doi.org/10.1128/aem.00810-26
  9. Ann Med Surg (Lond). 2026 Jun;88(6): 3864-3865
    Bacteriophage therapy for multidrug-resistant pediatric infections: a re-emerging precision antimicrobial strategy.
    Asra Amjad, Armeen Shahzad, Fred Segawa.
      
    DOI:  https://doi.org/10.1097/MS9.0000000000005020
  10. Eur Respir J. 2026 Jun 11. pii: 2600239. [Epub ahead of print]
    Bridging the airway microbiome and targeted therapy in bronchiectasis: multi-omics insights, endotypes and emerging therapies.
    Christina S Thornton, Laura Schaupp, Michael M Tunney, Marcus A Mall.
      Bronchiectasis is a heterogeneous chronic airway disease primarily driven by persistent infection, microbial dysbiosis and dysregulated host immunity. While culture-based microbiology has historically informed clinical management, advances in high-throughput sequencing and multi-omic technologies have transformed our understanding of the airway ecosystem, revealing that disease activity is shaped, not only by individual pathogens, but by complex and dynamic host-microbe interactions. Despite the breadth of descriptive microbiome data, translation into clinically actionable diagnostics or therapies has been limited. Importantly, cross-sectional correlations between microbiota and inflammation do not establish cause and effect, underscoring the need to embed host-microbiome profiling within both longitudinal and interventional therapeutic trials. In this review, we critically appraise current microbial and host multi-omics research in bronchiectasis, integrating microbiome studies with host inflammatory, proteomic and immunophenotyping data. We highlight themes emerging across cohorts, including low microbial diversity, pathogen dominance, loss of commensal networks and neutrophil-driven inflammation and discuss how these features align with biological endotypes associated with exacerbations and treatment response. Drawing on lessons from host-directed therapeutic successes, we examine translational roadblocks limiting microbiome-guided care. We further review emerging microbiome-modulating strategies such as pathogen-specific biologics, bacteriophage therapy, live biotherapeutic products, biofilm-targeting adjuncts and precision antibiotic stewardship. Finally, we propose a roadmap toward microbiome-informed precision medicine through harmonized methodologies, integration of host and microbial biomarkers into clinical trials and embedding multi-omics pipelines within large international registries. Collectively, these advances have the potential to shift bronchiectasis research and clinical management towards rationally designed, precision medicine-driven therapeutic strategies.
    DOI:  https://doi.org/10.1183/13993003.00239-2026
  11. Front Cell Infect Microbiol. 2026 ;16 1792361
    Artificial intelligence in optimizing antimicrobial therapy for gastro-renal disorders.
    Oana Stoia, Paula Anderco, Teona Badiu, Samuel Bogdan Todor, Cristian Ichim.
      Antimicrobial therapy remains central to the management of gastrointestinal and urinary tract infections, yet its effectiveness is increasingly compromised by antimicrobial resistance and antibiotic-induced microbiome disruption. These challenges are particularly pronounced in gastro-renal settings, where recurrent infections, altered drug absorption and impaired renal clearance generate substantial pharmacokinetic variability and narrow therapeutic margins. Empiric, guideline-based regimens may therefore contribute to treatment failure, resistance selection, and disease recurrence. Artificial intelligence (AI) and machine learning offer novel opportunities to optimize antimicrobial therapy by integrating clinical, microbiological and multi-omics data to predict resistance, guide antibiotic selection and dosing, and support antimicrobial stewardship. However, clinical translation remains limited by data heterogeneity, insufficient prospective validation, regulatory constraints, and the need for continued human oversight. This review synthesizes current AI-driven strategies relevant to gastro-renal infections, highlighting shared pathophysiological challenges, practical clinical applications and key limitations. An integrated framework for AI-assisted antimicrobial optimization is proposed to enhance therapeutic efficacy while mitigating antimicrobial resistance and preserving microbiome integrity.
    Keywords:  antibiotic treatment; antimicrobial resistance; artificial intelligence; gastrointestinal diseases; renal diseases
    DOI:  https://doi.org/10.3389/fcimb.2026.1792361
  12. Front Sociol. 2026 ;11 1817248
    Healing beyond the wound: social determinants in chronic vascular care. Perspectives from clinical practice.
    Davide Costa, Raffaele Serra.
       Background: Chronic vascular wounds are increasingly recognized as complex conditions shaped not only by vascular pathology but also by social determinants of health (SDHs). While research has focused primarily on patient outcomes, limited attention has been paid to how providers experience socially contextualized wound chronicity.
    Objective: To explore how wound care professionals understand, experience, and respond to SDHs influencing chronic vascular wound healing, and how these dynamics affect professional identity, moral distress, and workforce sustainability.
    Methods: A qualitative study was conducted using semi-structured interviews with 22 wound care professionals (home care nurses and hospital-based specialist nurses) in Calabria, Italy. Participants held post-graduate training in wound care and at least 1 year of clinical experience. Interviews were analyzed using reflexive thematic analysis following Braun and Clarke's six-phase approach.
    Results: Five interrelated themes emerged: recognition of upstream social inequalities; structural barriers embedded in clinical practice; invisible advocacy and emotional labor; moral distress linked to constrained professional agency; and implications for professional identity and retention. Providers reframed non-adherence as structurally produced and described chronic wounds as embodied expressions of inequality.
    Conclusion: Chronic vascular wounds function as visible markers of social inequality. Addressing healing disparities requires integrating SDHs into clinical frameworks and supporting providers facing structurally generated moral and organizational strain.
    Keywords:  chronic vascular wounds; moral distress; social determinants of health; structural vulnerability; wound care workforce
    DOI:  https://doi.org/10.3389/fsoc.2026.1817248
  13. Lancet Infect Dis. 2026 Jun 09. pii: S1473-3099(26)00176-3. [Epub ahead of print]
    Calciphylaxis complicated by NDM-1-producing Pseudomonas aeruginosa: first experience with cefepime-zidebactam alongside phage therapy in the USA.
    Erlinda R Ulloa, Daniel Jaffurs, M Tuan Tran, Carol Lin, Hung Tran, Dorian Chan, Ali Nael, Sagar U Nigwekar, Mikeljon P Nikolich, Daria Van Tyne.
      We report a case of calciphylaxis-a rare vasculopathy characterised by arteriolar calcification and ischaemic skin necrosis-in a young woman with acute myeloid leukaemia. Her ulcerated skin lesions became superinfected with a pan-resistant New Delhi metallo-β-lactamase-1-producing Pseudomonas aeruginosa. Although such infections in the USA have largely been associated with international travel, our patient harboured one of the earliest domestically acquired isolates. Management required novel therapeutic strategies, including the first use of cefepime-zidebactam in the USA alongside bacteriophage therapy and calciphylaxis-directed treatment. This case highlights the diagnostic complexity of calciphylaxis in atypical populations and shows the potential for innovative therapeutic approaches to achieve favourable outcomes in this rare, potentially fatal condition.
    DOI:  https://doi.org/10.1016/S1473-3099(26)00176-3
  14. J Wound Care. 2026 Jun;35(Sup6b): lxxv-lxxix
    Treating an unresponsive diabetic foot ulcer with cold atmospheric plasma, maggot therapy and alginate dressing: a case report.
    Navid Faraji, Rasoul Goli, Naser Parizad, Ramin Aliabbasi Ghoushchi, Amireh Hassanpour, Yousef Mohammadpour.
      Diabetic foot ulcers (DFUs) pose a common and intricate challenge for individuals with diabetes. Conventional wound care approaches may not always yield successful healing, necessitating alternative methods. This case report details the experience of a 65-year-old male patient with type 2 diabetes who presented with a hard-to-heal DFU on his right foot, categorised as a Wagner grade 4 DFU. Despite standard wound care management, which involved regular cleaning, debridement and dressings, the wound exhibited no signs of improvement over a six-week period. The patient underwent a comprehensive assessment by a multidisciplinary team, comprising a wound care specialist, nurse and podiatrist, leading to the formulation of a tailored treatment plan. The treatment regimen encompassed four stages: cold atmospheric plasma therapy, maggot therapy, application of alginate dressing and continuous monitoring. Following eight weeks of treatment, notable enhancements were observed in the management of the DFU.
    Keywords:  alginate dressing; cold atmospheric plasma; diabetic foot ulcer; maggot therapy; wound; wound care; wound dressing; wound healing
    DOI:  https://doi.org/10.12968/jowc.2023.0238
  15. NPJ Biofilms Microbiomes. 2026 Jun 12.
    Decoding phage communication: molecular networks, evolutionary dynamics, and therapeutic applications.
    Sahar Abed, Mohammad Sholeh, Sara Sadeghi, Ameneh Khatami, Peter Speck, Morvarid Shafiei.
      Communication between bacteriophages, particularly in biofilms, has long been studied. The recent discovery of the arbitrium lysis-lysogeny switch in Bacillus phages, similar to bacterial quorum sensing, has renewed interest in phage communication. This review examines the arbitrium system alongside other switching mechanisms, explores its role in pathogen-phage-host immune interactions, and proposes design principles for "smart" phage therapies.
    DOI:  https://doi.org/10.1038/s41522-026-01050-3
  16. BioDrugs. 2026 Jun 12.
    Giving Antibiotics a Second Chance: Evolutionary Trade-Offs and Phage-Driven Restoration of Antibiotic Susceptibility.
    Michał Wójcicki, Martyna Cieślik, Andrzej Górski, Ewa Jończyk-Matysiak.
      Antimicrobial resistance poses a critical and escalating threat to global public health, driven by the widespread and often unjustified use of antibiotics and the rapid dissemination of resistance determinants. With the antibiotic discovery pipeline largely depleted, alternative and complementary strategies are urgently needed to preserve the effectiveness of existing antimicrobials. Bacteriophages-viruses that specifically infect bacteria-have re-emerged as promising tools not only for direct bacterial eradication but also for reshaping bacterial evolutionary trajectories. This review examines the concept of phage-driven restoration of antibiotic susceptibility, focusing on evolutionary trade-offs that arise when bacteria adapt to phage pressure. Resistance to bacteriophages frequently involves modifications of surface structures, capsules, or efflux systems, changes that often incur fitness costs manifested as reduced virulence, impaired biofilm formation, or increased antibiotic sensitivity. Experimental studies and clinical case reports demonstrate that phage-antibiotic synergy can suppress bacterial growth more effectively than monotherapy, limit resistance emergence, and resensitize multidrug-resistant pathogens to previously ineffective antibiotics. Particular attention is given to mechanisms involving efflux pump targeting, capsule loss, biofilm disruption, and temperate phage-antibiotic interactions. In addition, emerging strategies that combine bacteriophages with CRISPR-Cas systems enable precise targeting and removal of resistance genes, offering a highly selective means to restore antibiotic efficacy and curb horizontal gene transfer. Together, these findings highlight bacteriophages as powerful evolutionary and therapeutic tools capable of giving antibiotics a "second chance". Integrating phage-based approaches into antibiotic stewardship frameworks may represent a sustainable path forward in combating multidrug-resistant bacterial infections.
    DOI:  https://doi.org/10.1007/s40259-026-00789-7
  17. Nature. 2026 Jun;654(8118): 560-562
    AI is taking on antibiotic resistance - here's how.
    Jyoti Madhusoodanan.
      
    Keywords:  Antibiotics; Chemistry; Machine learning; Microbiology
    DOI:  https://doi.org/10.1038/d41586-026-01818-9
  18. J Prof Nurs. 2026 Jul-Aug;65:pii: S8755-7223(26)00073-6. [Epub ahead of print]65 118-136
    Teaching methods in wound care in nursing education: A scoping review.
    Emilia Kielo-Viljamaa, Elina Wallius, Minna Stolt.
       BACKGROUND: In wound care education, there is evidence of competence areas and learning goals. However, evidence of teaching methods needs to be determined.
    AIM: To describe the teaching methods used in wound care education for nursing professionals and students, and to describe how these methods affect or are related to their competence and other outcomes in wound care and prevention.
    METHODS: The scoping review followed JBI methodology. Two researchers searched databases including MEDLINE (PubMed), CINAHL (EBSCO), Cochrane Library, Scopus, and ERIC in November 2024. Evidence was selected by screening titles and abstracts, and then reviewing full texts. Evidence was categorised by themes, with outcomes summarised narratively. The search was updated in March 2026.
    RESULTS: The authors of the 48 articles focused on undergraduate nursing education and pressure ulcer prevention. The six main teaching methods were: technology-enhanced methods, gaming, lecturing, simulation, reflective methods, and workshops. Simulation was most common. Teaching methods indicated mainly positive results, although some outcomes showed no change in students' or professionals' wound care competence.
    CONCLUSIONS: All teaching methods resulted in positive outcomes in at least one dimension of competence among nurses and students. Nurse educators can use these to enhance knowledge and skills. However, findings should be interpreted cautiously due to the scoping nature of the review.
    Keywords:  Nursing education; Teaching; Wound management; Wounds and injuries
    DOI:  https://doi.org/10.1016/j.profnurs.2026.05.002
  19. Virulence. 2026 Jun 11. 2687214
    Biofilm-mediated antibiotic tolerance in bacterial pathogens: Integrated molecular networks and novel therapeutic avenues.
    Qian Zhang, Rong Lin, Yanrui Zhao, Peirui Zhan, Xin Zhao, Wei Zou.
      The stable structure of biofilms and the characteristics of the bacteria within them make biofilms an important barrier for bacteria to resist external stress, and a key factor contributing to the difficulty of eradicating clinical infections. This article reviews the multi-stage formation process of biofilms, the various mechanisms of antibiotic tolerance and resistance (such as physical barriers, metabolic adaptations, horizontal gene transfer, etc.), as well as the integrated regulatory roles of molecular networks like quorum sensing (QS) and cyclic diguanosine monophosphate (c-di-GMP). These multiple protective mechanisms in biofilms compose a closed "structure-function" loop system. In the past few years, the emergence of new anti-biofilm intervention approaches (matrix-degrading enzymes, phage therapy, nanomaterials, gene editing, etc.) revealed the possibility to break the limitations of conventional antibiotics by compromising structural integrity or interfering with signaling pathways, providing new ideas for drug-resistance infection control.
    Keywords:  Biofilm; C-di-GMP; QS; antibiotic resistance; antibiotic tolerance; artificial intelligence (AI); extracellular polymeric substances (EPS); nanoparticle drug delivery; persister cells
    DOI:  https://doi.org/10.1080/21505594.2026.2687214
  20. Ann Med Surg (Lond). 2026 Jun;88(6): 3045-3047
    The skin microbiome: the overlooked axis in modern dermatology.
    Rania Saad Ibrahim Abdelghany Elbeshbishy, Adnan Khatak.
      The skin microbiome plays a critical role in maintaining cutaneous barrier integrity, modulating immune responses, and influencing the expression of dermatologic disease, yet its integration into clinical practice remains limited. Microbial alterations have been described in conditions such as atopic dermatitis, acne vulgaris, psoriasis, and chronic wounds; however, uncertainty regarding causality, interindividual variability, and lack of methodological standardization have hindered clinical translation. Current diagnostic frameworks rarely incorporate microbial metrics, while antimicrobial therapies remain central to management, often without consistent consideration of their ecological impact. Emerging microbiome-directed strategies, including topical probiotics, bacteriophage therapy, and microbiome-preserving approaches, show early promise but lack robust clinical validation. Advancing the role of the skin microbiome in dermatology will require standardized research methodologies, integration of multi-omics approaches, and well-designed clinical trials with clinically meaningful outcomes. This editorial highlights the need for a balanced and evidence-based framework that incorporates microbial perspectives into dermatology without overstating current evidence, advocating for a gradual integration that complements established immunologic and barrier-focused paradigms.
    Keywords:  acne vulgaris; antimicrobial stewardship; atopic dermatitis; cutaneous dysbiosis; microbiome-directed therapy; skin microbiome
    DOI:  https://doi.org/10.1097/MS9.0000000000005009
  21. Scand J Immunol. 2026 Jun;103(6): e70128
    Virulence Factors of Porphyromonas gingivalis in Periodontitis and Rheumatoid Arthritis: Clinical Implications.
    S Silva Daniela, Kaminska Marta, Mizgalska Danuta, Potempa Jan, de Vries Charlotte, Lundberg Karin, P da Silva José António, P Baptista Isabel, Mydel Piotr.
      Porphyromonas gingivalis (P. gingivalis), has been implicated in exacerbating inflammatory arthritis through its virulence factors. Understanding the role of these factors could inform strategies to mitigate both periodontal and synovial inflammation. This study aimed to investigate the prevalence of P. gingivalis virulence factors and their potential impact on disease activity in patients with periodontitis, rheumatoid arthritis (RA), or both conditions. Patients with RA (n = 22), RA plus periodontitis (n = 22), periodontitis (n = 10), and healthy controls (n = 35), were compared for C-reactive protein levels, anti-cyclic citrullinated peptide IgG, peptidylarginine-deiminase (PAD)2/4 activity and anti-P. gingivalis virulence-associated gingipain antibodies. All patients with periodontitis were compared for P. gingivalis, Tannerella forsythia and Prevotella intermedia colony-forming units, and gene variants of P. gingivalis, including PAD (P.PAD), major fimbriae (fimA), lysine-gingipain (kgp), and receptor antigen gene B (ragB). Higher mean clinical periodontal attachment loss was observed with P.PAD type 1 (p = 0.033). The major fimbriae and lysine-gingipain gene variants showed distinct distributions between groups. Anti-gingipain IgG levels showed positive correlations with RA disease activity. Despite limitations, this study supports a role for P. gingivalis in exacerbating periodontitis and RA underscoring the importance of P. gingivalis virulence factors in disease modulation and highlighting potential therapeutic strategies. Further research is needed to elucidate mechanistic pathways and develop effective interventions. Trial Registration: ISRCTN 17950307; https://doi.org/10.1186/ISRCTN17950307.
    Keywords:   P. gingivalis ; genotyping; periodontitis; rheumatoid arthritis; virulence factors
    DOI:  https://doi.org/10.1111/sji.70128
  22. J Periodontal Implant Sci. 2026 Apr 10.
    The role of miR-155 and IL-6 in the shared pathogenesis of periodontitis and rheumatoid arthritis: a cross-sectional case-control study.
    Kratee Sharma, Archisha Bansal, Veerubhotla Shanmuka Kedarnath, Kothinti Sreevathsa Reddy, Shweta Aggarwal, Chirag Gupta, Seema Gupta, Manish Sharma.
       PURPOSE: Periodontitis (PD) and rheumatoid arthritis (RA) share inflammatory pathways, with interleukin-6 (IL-6) and microRNA-155 (miR-155) implicated as key mediators. This study quantified salivary IL-6 and serum miR-155 levels across 4 groups (PD only, RA only with a healthy periodontium, comorbid PD+RA, and healthy controls) and examined their associations with clinical severity indices of both diseases.
    METHODS: This cross-sectional case-control study enrolled 120 participants (30 per group). Periodontitis was diagnosed according to the 2017 American Academy of Periodontology/European Federation of Periodontology classification, and RA was diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Salivary IL-6 and serum miR-155 were measured using quantitative real-time polymerase chain reaction.
    RESULTS: Combined salivary IL-6 and serum miR-155 expression differed significantly across groups (multivariate analysis of covariance, Pillai's trace=0.892, P<0.001), with the highest levels observed in the comorbid group. Both biomarkers showed strong positive correlations with periodontal clinical parameters (Spearman ρ=0.704-0.958) and moderate-to-strong correlations with RA disease activity measures (ρ=0.391-0.782; all P<0.001). The periodontal severity composite score explained 94.3% of the variance and correlated most strongly with IL-6 (ρ=0.958). Receiver operating characteristic analyses yielded area under the curve (AUC) values of 0.75-1.00, including perfect discrimination (AUC=1.00) in multiple comparisons.
    CONCLUSIONS: Salivary IL-6 and serum miR-155 were strongly associated with the presence and severity of both PD and RA and were markedly elevated in comorbid cases, supporting their potential as biomarkers. Longitudinal studies are needed to establish temporality and causality.
    Keywords:  Interleukin-6; Linkage; MicroRNA; Periodontitis; Rheumatoid arthritis
    DOI:  https://doi.org/10.5051/jpis.2504300215
  23. J Periodontal Res. 2026 Jun 12.
    Periodontitis and Rheumatoid Arthritis-Mechanistic Evidence.
    Mark Bartold, Chia Wei Cheah, Rathna Devi Vaithilingam.
      Current evidence strongly supports an association between periodontitis and rheumatoid arthritis (RA) in a subset of susceptible individuals. The relationship between these conditions is underpinned by a complex interplay between chronic inflammation and subgingival bacterial infection. Several hypotheses have been proposed to explain the mechanistic basis of this association. Among these, the "two-hit" model is particularly compelling, as it suggests that inflammation, infection, or a combination of both may contribute to the initiation and progression of RA in predisposed individuals. According to this model, the progression of gingivitis and periodontitis, together with associated microbial dysbiosis, may promote protein citrullination, carbamylation, and the formation of malondialdehyde-acetaldehyde (MAA) adducts. These post-translational modifications may subsequently induce the production of autoantibodies before the clinical onset of joint inflammation and RA. Once synovial inflammation develops, additional citrullination, carbamylation, and MAA adduct formation may occur within the joint microenvironment, further amplifying autoantibody production. In previously sensitized individuals, such as those with chronic gingivitis or periodontitis, this secondary immune response may be substantially enhanced, resulting in increased joint inflammation and tissue destruction. Subgingival bacteria may also contribute directly, or indirectly, to the periodontitis/RA axis through translocation to distant tissues, induction of protein citrullination and other protein post-translational modifications, stimulation of autoantibody production, and exacerbation of inflammatory responses. Central to the role bacteria play in the periodontitis/RA axis is the emergence of functional alterations in the microbiome. Dysbiosis in the subgingival microenvironment, and the emergence and proliferation of recognized periodontal pathobionts, underpins these key elements. This, along with bacterial-induced inflammation and direct influence on immune player trafficking, results in a complex synergy within the mechanistic processes involved in the relationship between periodontitis and RA. In this narrative review, we critically examine the inflammatory and microbial mechanisms implicated in the interaction between periodontitis and RA and propose an updated framework integrating inflammation, dysbiosis, and autoimmunity.
    Keywords:  bacterial biofilm; inflammation; periodontitis; rheumatoid arthritis
    DOI:  https://doi.org/10.1111/jre.70132
  24. Acta Biomater. 2026 Jun 12. pii: S1742-7061(26)00382-X. [Epub ahead of print]
    Multifunctional Bioengineered Scaffolds and Adjunct Therapeutic Strategies for Diabetic Foot Ulcers.
    Shahab Edalatian Zakeri, Pratheesh Kanakarajan Vijaya Kumari, Sania Malik, Aliyan Aamir, Leeza Kumar, Vineeth M Vijayan, Patrick T J Hwang.
      Diabetic foot ulcers (DFUs) are chronic, non-healing wounds that affect up to 34% of diabetic patients. DFUs are complicated by infection in nearly 60% of cases and frequently progress to amputation. DFU pathology is characterized by a persistent inflammatory state, impaired angiogenesis, and infection. This creates a complex microenvironment refractory to standard care, with fewer than 20% of DFUs healing within 8 weeks. In this review article, normal and pathophysiological processes of wound healing, current clinical management strategies, and adjunct therapeutics in the clinical pipeline are discussed, followed by recent advances in multifunctional bioengineered platforms. These platforms are categorized into three main systems: hydrogels, electrospun dressings, and 3D-bioprinted constructs, in addition to hybrid fabrication approaches and the integration of low-temperature plasma therapy as emerging multi-targeted strategies. For hydrogels, stimuli-responsive designs that respond to mechanical force, pH, glucose, and excess reactive oxygen species to actively modulate drug release and scaffold behavior are discussed. For electrospun scaffolds, strategies for controlled, multi-therapeutic delivery, including fiber blending, surface conjugation, and core-shell architectures are reviewed. Next, 3D bioprinting as a platform for patient-specific, cell-laden constructs is presented and covers major fabrication techniques and the emerging potential of handheld in situ bioprinters for accelerating clinical translation. Multi-targeted hybrid approaches that combine these platforms, along with the synergistic integration of low-temperature plasma therapy for broad-spectrum antimicrobial action, biofilm disruption, and immune modulation are emphasized. Unlike prior material-centric reviews, this review adopts a function-driven framework that organizes scaffold systems based on their ability to address key DFU pathologies, including infection, inflammation, impaired angiogenesis, and delayed healing, providing a more clinically relevant perspective. Finally, emerging directions such as artificial intelligence (AI)-guided design, in situ bioprinting, and recent clinical trends are discussed to bridge scaffold design with translational application. STATEMENT OF SIGNIFICANCE: Diabetic foot ulcers (DFUs) present a critical global health challenge characterized by a highly inflammatory microenvironment that remains refractory to standard care. This review elucidates the paradigm shift from passive wound dressings to "intelligent," multifunctional bioengineered scaffolds designed to actively modulate DFUs. We critically examine recent advances in stimuli-responsive hydrogels (pH-, glucose-, and reactive oxygen species-sensitive), mechanically active contractile patches, complex electrospun architectures, and 3D bioprinting. Furthermore, by integrating emerging technologies such as handheld in situ 3D bioprinting, low-temperature plasma therapy, and artificial intelligence-driven design, this work provides a roadmap for the next generation of precision biomaterials capable of overcoming specific biological barriers to regeneration in chronic wounds.
    Keywords:  3D Printing; AI-guided Wound Management; Chronic Inflammation; Diabetic Foot Ulcers; Electrospun Scaffolds; Hydrogels; Low-Temperature Plasma
    DOI:  https://doi.org/10.1016/j.actbio.2026.06.020
  25. J Alzheimers Dis. 2026 Jun 12. 13872877261456324
    A mechanistic framework linking the oral microbiome to Alzheimer's disease through neuroinflammation.
    Manon J A P Evers, Bastiaan P Krom, Caroline A de Jongh.
      Alzheimer's disease (AD) is a growing problem in our society and the most common form of dementia. This neurodegenerative disease is characterized by neuroinflammation and the accumulation of amyloid-β (Aβ) and tau. Previous studies have found associations between the oral microbiome and AD. This review aims to elucidate the role of the oral microbiome in AD, through neuroinflammation, and reviews the relationship between AD and bacteria and fungi. Studies have found bacteria (e.g., Porphyromonas gingivalis) and fungi (e.g., Candida albicans) in postmortem AD brains. Moreover, mice models have shown that oral microbes are able to cross the blood-brain barrier (BBB), and were correlated with activated microglia, neuroinflammation, and Aβ load. This review introduces a mechanistic framework that describes how oral microbes cause an inflammatory response resulting in AD pathology. Specifically, oral dysbiosis causes oral pathogens to disseminate into the bloodstream, this triggers an inflammatory response, subsequently activating microglia, ultimately resulting in AD pathology. This process can follow two pathways: First, there is a direct response of the immune system in the brain to oral pathogens that migrate through the bloodstream and cross the BBB, which causes neuroinflammation and activates microglia, leading to AD pathology. Second, an early-life systemic inflammation causes microglia to get into a "hyperactive" state, in which they respond in an exaggerated way to normal stimuli triggering immune responses throughout a person's life that result in AD pathology. This mechanistic framework provides new line of thought for future research on the question of causality of AD.
    Keywords:  Alzheimer's disease; bacteria/microbiome/microbiota; microglia; neuroinflammation; periodontal disease
    DOI:  https://doi.org/10.1177/13872877261456324
  26. Front Cell Infect Microbiol. 2026 ;16 1826972
    From dysbiosis to precision medicine: targeting the microbial-metabolic axis in IBD management.
    John K Giju, Subin John, Amrutha Sivadas, Meera Prabhakar, Krishnakripa K, Damu Sunilkumar, Bipin G Nair, Sanjay Pal, Vidhya Prakash.
      Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory condition that has a rapidly changing global epidemiology. IBD has been traditionally viewed as a primary immune system dysfunction, but emerging evidence more accurately describes IBD as a perturbance of the intricate balance between host immunity, the intestinal microbiome, and intestinal metabolism. Although genetic and environmental components have long been recognized as contributors, accumulating evidence increasingly highlights the pivotal role of microbial dysbiosis in the pathogenesis of IBD. In patients with IBD, intestinal dysbiosis, which is often characterized by reduced Firmicutes and increased pro-inflammatory bacteria, triggers a cascade of pathogenic events. These pathogenic events include impaired epithelial barrier function, dysregulated immune activation against luminal antigens, and immune reprogramming. Central to these processes are functional changes in microbial metabolism, particularly in pathways involving short-chain fatty acids (SCFAs), bile acids, and redox homeostasis, which critically contribute to the development of chronic mucosal inflammation. The current therapeutic backbone of IBD-including aminosalicylates, biologics, and immunomodulators-largely targets the inflammatory response. However, the challenges such as primary non-response, secondary loss of response, and systemic side effects are often problematic. Consequently, there is an urgent need to develop novel therapeutic and preventive strategies that target the underlying microbial and metabolic causes of the disease rather than modulating immune responses. This review integrates the pathomechanistic implications of the microbiome-metabolic axis in the maintenance of gut homeostasis and its disruption in IBD, with particular emphasis on the global epidemiology of the disease. We further evaluate emerging therapeutic and preventive strategies aimed at restoring the microbiome-metabolic axis, including fecal microbiota transplantation (FMT), probiotic therapy, bacteriophage therapy, and helminth-based therapies. In addition, we explore the potential of advanced approaches such as microbiome engineering and precision genome editing to enable highly personalized therapeutic paradigms. By bridging microbial ecology with clinical pathology, this review highlights the transformative potential of targeting the host-microbiota interface to achieve improved long-term outcomes in IBD.
    Keywords:  Crohn’s disease; SCFA (short-chain fatty acid); gut dysbiosis; intestinal homeostasis; machine learning; metagenomics; probiotics; ulcerative colitis
    DOI:  https://doi.org/10.3389/fcimb.2026.1826972
  27. Can J Physiol Pharmacol. 2026 Jun 11.
    Exploring the causal relationship between inflammatory cytokines and diabetic foot ulcer: A bidirectional Mendelian randomization and clinical validation study.
    Jianyi Liu, Hao Tan, Yan Liu, Zhentan Lu, Weibing Zhong, Zehao Niu.
      Diabetic foot ulcers (DFU) are a major complication of diabetes, often driven by chronic inflammation. The role of specific inflammatory cytokines in DFU development is unclear due to challenges in observational studies. This study used a two-sample, bidirectional Mendelian randomization (MR) approach to assess the causal effects of 41 circulating inflammatory cytokines on DFU risk. Instrumental variables were selected based on genome-wide significance and linkage disequilibrium criteria. The primary analysis was inverse-variance weighted (IVW), with validation through enzyme-linked immunosorbent assay (ELISA) and real-time PCR (RT-PCR) in DFU patients and controls. Genetically predicted levels of CTACK (CCL27) and MIG (CXCL9) were linked to reduced DFU risk, with odds ratios of 0.538 for CTACK and 0.501 for MIG. Sensitivity analyses confirmed the robustness of the findings. Reverse MR analysis showed no causal relationship between DFU and these cytokines. Clinical validation revealed lower protein and mRNA levels of CTACK and MIG in DFU patients. This study provides evidence for a protective role of CTACK and MIG in DFU development, suggesting they could serve as biomarkers or therapeutic targets for diabetic wound care.
    DOI:  https://doi.org/10.1139/cjpp-2025-0320
  28. Cureus. 2026 May;18(5): e108593
    Characterization and Clinical Implications of Multidrug-Resistant Klebsiella pneumoniae in ICU Patients in India: A Comprehensive Review.
    Geeta Karande, Shivaji T Mohite, Satish Karande, Satish Patil.
      Multidrug-resistant (MDR) Klebsiella pneumoniae has become a prominent cause of healthcare-associated infections, especially in Intensive Care Units (ICUs), constituting a major threat to patient outcomes and healthcare systems. This review examines the epidemiology, risk factors, mechanisms of antimicrobial resistance, virulence determinants, clinical manifestations, treatment approaches, infection control measures, and future perspectives of MDR K. pneumoniae, with particular emphasis on the Indian context. The rising incidence of carbapenem-resistant and hypervirulent strains has severely restricted available therapeutic choices, leading to higher mortality rates, prolonged hospital stays, and increased healthcare costs. Resistance is largely driven by mechanisms such as extended-spectrum β-lactamase (ESBL) and carbapenemase production, along with plasmid-mediated gene transfer, which facilitates rapid spread. Furthermore, virulence determinants such as capsule production, siderophore systems, and biofilm formation contribute to increased pathogenicity. Treatment remains difficult because of the scarcity of effective antibiotics, often requiring combination therapies and the investigation of novel treatment modalities. Reinforcing infection control practices, antimicrobial stewardship, and surveillance systems is crucial to curb the spread of MDR strains. Additionally, emerging approaches such as rapid diagnostic tools, genomic surveillance, and artificial intelligence-based predictive models offer potential for early detection and improved clinical outcomes.
    Keywords:  antimicrobial resistance carbapenem resistance; icu infections; india; infection control; multidrug-resistant klebsiella pneumoniae
    DOI:  https://doi.org/10.7759/cureus.108593
  29. Front Oral Health. 2026 ;7 1798339
    Risk factors for the emergence of multidrug-resistant bacteria in patients with head and neck infections: a retrospective analysis.
    Dorottya Diana Kiss, Daniel Sandor Veres, Krisztina Marton, Zsolt Nemeth, Arpad Joob-Fancsaly, Katalin Kristof.
       Background: The emergence and spread of multidrug-resistant (MDR) pathogens have been linked to excessive antibiotic use, as well as patient-related factors such as hospitalization. This study investigated the clinical determinants of antimicrobial resistance (AMR) and the occurrence of MDR bacteria.
    Methods: We evaluated 4,492 bacterial isolates from 1,719 patients and analyzed the association between resistance levels and various patient-related factors, including age, primary diagnosis, comorbidities, oral hygiene, smoking, alcohol use, and prior antibiotic therapy. AMR rate was graded from 0 to 3, and a mixed-effect continuation ratio was used for the analysis.
    Results: Patients with oral cancer (OR 1.38, 95% CI 1.06-1.80), a history of smoking (OR 1.19, 95% CI 1.01-1.41), immunosuppressive therapy (OR 1.36, 95% CI 1.06-1.75), insulin-treated diabetes (OR 1.57, 95% CI 1.05-2.35), or cardiovascular disease (OR 1.28, 95% CI 1.02-1.61) had significantly higher risk of infection with MDR bacteria. Prior antibiotic use (OR 1.44, 95% CI 1.24-1.68), older age (OR 1.01, 95% CI 1.00-1.01), and female sex (OR 1.28, 95% CI 1.09-1.49) were also significantly associated with progression to multidrug resistance.
    Conclusions: These findings suggest that, beyond selective pressure from antibiotics, individual patient characteristics may also contribute to the development of MDR bacteria in head and neck infections and. Clinicians should consider these factors during hospitalization, particularly regarding infection prevention and the responsible selection of antibiotics.
    Keywords:  antimicrobial resistance; head and neck infections; multidrug-resistant bacteria; odontogenic infections; oral cancer; risk factors; surgical site infections
    DOI:  https://doi.org/10.3389/froh.2026.1798339
  30. Infect Drug Resist. 2026 ;19 614240
    Artificial Intelligence for Antimicrobial Resistance Detection and Prediction in Klebsiella pneumoniae: A Systematic Review of Clinical Microbiology Applications.
    Raghav Vinay Aggarwal, Nisarg Shah, Jolie Jin En Wong, Zaid Dajani.
       Background: Klebsiella pneumoniae is a WHO critical-priority pathogen associated with a substantial antimicrobial resistance (AMR) burden. Conventional microbiology workflows, including antimicrobial susceptibility testing, often require 36-72 hours, prolonging empirical therapy and contributing to antibiotic overuse. Artificial intelligence (AI) has emerged as a promising approach for enhancing the detection and prediction of antimicrobial resistance.
    Methods: We searched four databases (PubMed, EMBASE, MEDLINE, and CENTRAL) from 1 January 2010 to 3 January 2026 for peer-reviewed, original research studies evaluating AI methods for the detection and/or prediction of AMR in K. pneumoniae. Studies without K. pneumoniae-specific extractable outcomes were excluded. Data on study characteristics, input modalities, AI methods, performance, workflow gains, and validation methods were extracted and narratively synthesised. Risk of bias was assessed using PROBAST and QUADAS-2 according to study design.
    Results: Fifty-seven studies were included, with publication output accelerating sharply in 2024-2025 (27/57, 47.4%). Most studies originated from East Asia and predominantly aimed to classify resistance phenotypes from pre-AST data (37/57, 64.9%) using machine learning approaches. MALDI-TOF mass spectrometry was the most common input modality (27/57, 47.4%), followed by genomic sequencing and vibrational spectroscopy (12/57 each, 21.1%). Random forests were the most frequently studied model family (28/57, 49.1%), with high reported discrimination. Among AUROC/AUC-primary studies, 26/35 (74.3%) reported best-model performance ≥0.90; however, overall risk of bias was high, present in 45/57 studies (78.9%). Internally validated study designs predominated, with external validation reported in only 17/57 studies (29.8%), and prospective, real-world evaluation in 1/57.
    Conclusion: AI-based AMR prediction and detection in K. pneumoniae is advancing rapidly, with MALDI-TOF-enabled approaches appearing most readily translatable to clinical microbiology workflows. However, the field remains dominated by retrospective, internally validated studies, often using imperfect automated susceptibility systems as reference standards. Progress now depends on rigorous external and prospective multicentre validation using geographically diverse datasets.
    Keywords:  Klebsiella; antimicrobial resistance; artificial intelligence; deep learning; machine learning; systematic review
    DOI:  https://doi.org/10.2147/IDR.S614240
  31. Front Bioeng Biotechnol. 2026 ;14 1789373
    Antibody display technologies from phages to cells: translational bottlenecks and AI-enabled opportunities.
    Amrita Sahu, Punyatoya Das, Rohit Das, Indrajit Bhattacharya, Teeshyo Bhattacharya, Utpal Mohan, Remya Sreedhar, Somasundaram Arumugam.
      Beginning with the pioneering hybridoma technology developed in 1975, antibody generation methodologies have advanced substantially, culminating in today's single-cell techniques. Each successive approach contributes unique applications, advantages, and drawbacks that reflect the field's dynamic progress. We highlight the impact of integrating single-cell RNA sequencing (scRNA-seq) with display technologies. This holds potential for the healthcare industry by enabling efficient identification and development of diagnostic and therapeutic antibodies. Monoclonal antibodies (MAbs) produced via each major technology are discussed to illustrate practical outcomes. We have also explored the essential role of glycosylation in maintaining antibody stability and function. Furthermore, we discussed single-cell RNA sequencing (scRNA-seq) that enables high-resolution profiling of immune repertoires and tumour heterogeneity, facilitating the identification of antigen-specific antibodies and rare cell populations. Integration with microfluidics and computational analysis enhances biomarker discovery and cell-specific resolution. These advances support personalised therapies and accelerate next-generation antibody discovery. Finally, we address the emerging integration of machine learning and artificial intelligence in antibody discovery, emphasising recent advances in epitope mapping and predicting three-dimensional protein structures from primary amino acid sequences. Collectively, these developments are poised to revolutionise antibody engineering and expand its impact on therapeutic innovation.
    Keywords:  antibody library; artificial intelligence (AI); display technology; monoclonal antibody; phage
    DOI:  https://doi.org/10.3389/fbioe.2026.1789373
  32. BMC Nurs. 2026 Jun 08.
    Exploring nurses' experiences of the presence of a wound care specialist: a qualitative study.
    Ziba Farzi, Saba Farzi, Nahid Madhani, Masoud Sharifian.
       BACKGROUND: Wound care is a critical aspect of nursing practice, yet nurses often face challenges related to limited knowledge, lack of structured training, and insufficient organizational support. The integration of specialist wound care nurses has been suggested to enhance clinical outcomes, continuity of care, and professional competence among nursing staff. This study aimed to explore nurses' experiences with a specialist wound care nurse in a hospital setting and to identify the impact of this role on clinical practice and team performance.
    METHODS: A qualitative descriptive-exploratory study was conducted in 2024-2025 at a specialized surgical and trauma care center in Iran. Ten participants, including staff nurses, head nurses, a specialist wound care nurse, and a nursing instructor, were recruited through purposeful sampling with maximum variation. Data were collected via semi-structured interviews (average duration: 35 min) and field notes, and analyzed using Graneheim and Lundman's qualitative content analysis framework. Trustworthiness was ensured through credibility, dependability, transferability, and confirmability strategies.
    RESULTS: Four main categories emerged: Specialized Wound Care, Continuity of Wound Care, Empowerment of Nurses, and Challenges and Strategies for Improvement. Specialist nurses enhanced evidence-based decision-making, improved care quality, accelerated wound healing, and reduced complications. They facilitated continuous, coordinated care across wards and empowered other nurses through clinical education and experiential learning. Barriers included staff shortages, undefined organizational positions, and insufficient managerial support, highlighting the need for structural and policy interventions.
    CONCLUSION: The presence of a specialist wound care nurse positively influences patient outcomes, care continuity, and professional development of nursing staff. For sustainable implementation, organizational support, formalized positions, adequate staffing, and Interprofessional education are essential. Integrating this role into hospital systems can foster safe, evidence-based, and patient-centered wound management.
    Keywords:  Advanced nursing; Continuity of care; Nurse empowerment; Qualitative content analysis; Specialist nurse; Wound care; Wound management
    DOI:  https://doi.org/10.1186/s12912-026-04845-z
  33. Biochem Biophys Res Commun. 2026 Jun 08. pii: S0006-291X(26)00885-5. [Epub ahead of print]828 154121
    Isolation and characterization of a lytic phage targeting carbapenem-resistant Pseudomonas aeruginosa.
    Panhong Jia, Xiangqin Wang, Yi Jian, Ruoyang Zhao, Ziqi Fang, Yunqi Li, Min Wu, Ke Wang.
      Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a major clinical challenge because of the limited availability of effective treatment options. In this study, we isolated four phages, designated Zpj1-Zpj4, from hospital sewage samples using the clinical strain CRPA-11d as the host. Genomic analysis showed that these phages were closely related double-stranded DNA phages and lacked identifiable genes associated with lysogeny, virulence, or antibiotic resistance. Taxonomic analysis assigned them to the genus Yuavirus, subfamily Rabinowitzvirinae, family Mesyanzhinovviridae, and class Caudoviricetes. Among them, phage Zpj4 was selected for further characterization. Its biological properties were evaluated by determining genomic features, optimal multiplicity of infection (MOI), one-step growth kinetics, host range, efficiency of plating (EOP), stability, and in vitro antibacterial and anti-biofilm activities. Its therapeutic efficacy was further assessed in a CRPA-11d induced mouse model of acute lung injury by measuring bacterial burdens in the lungs, livers, and spleens, together with lung histopathology. Phage Zpj4 exhibited favorable properties, including a short latent period, a high burst size, and strong stability. It markedly inhibited CRPA-11d growth and biofilm formation in vitro. In the mouse model, phage Zpj4 treatment significantly reduced bacterial burdens in the lungs, livers, and spleens and alleviated lung tissue injury. These findings indicated that phage Zpj4 is a promising candidate for the treatment of CRPA infections.
    Keywords:  Acute lung injury; Biofilm; Carbapenem-resistant; Genomic analysis; Phage therapy; Pseudomonas aeruginosa
    DOI:  https://doi.org/10.1016/j.bbrc.2026.154121
  34. World J Pediatr. 2026 Jun 09.
    Artificial intelligence in pediatric intensive care units: current applications in sepsis management.
    Sheng Fu, Fei Li, Su-Yun Qian.
       BACKGROUND: Early detection of sepsis in pediatric intensive care units (PICUs) is critical, but challenging due to its nonspecific clinical presentation and marked physiological heterogeneity. Artificial intelligence (AI) offers transformative potential for precision sepsis management, but clinical translation remains complex due to methodological and implementation barriers.
    DATA SOURCES: A systematic review was conducted on the application of AI in sepsis management in PICUs. We included original research studies, meta-analyses, systematic reviews, clinical guidelines, and consensus statements. Databases searched included PubMed, Embase, Cochrane Library, Web of Science, Google Scholar, the China National Knowledge Infrastructure, and Wan Fang, covering records from inception to March 2026. Search terms included "artificial intelligence", "machine learning", "deep learning", "pediatric sepsis", "neonatal sepsis", "pediatric intensive care unit", and "Clinical Decision Support Systems".
    RESULTS: AI models consistently outperformed traditional pediatric scoring systems in both early prediction and risk stratification. Our comparative analysis indicates that while random forest models are more robust for discrete, cross-sectional data, long short-term memory networks excel at capturing the dynamic temporal patterns inherent in pediatric physiology. AI-driven clinical decision support systems were found to significantly improve adherence to standardized sepsis bundles; however, false-positive rates varied across healthcare tiers, exposing critical disparities in electronic health record infrastructure. Furthermore, multi-omics integration identified distinct biological endotypes, offering a path towards personalized therapy. Economic evaluations suggest these tools can reduce per-patient costs and optimize PICU resource allocation. Of note, recent global health policies now emphasize pediatric-specific validation and algorithmic fairness as prerequisites for equitable deployment of AI.
    CONCLUSIONS: Despite its technical superiority in the management of pediatric sepsis, the clinical utility of AI hinges on enhancing the transparency of "black-box" algorithms through explainable AI and narrowing the systemic infrastructure divide across healthcare tiers. Establishing robust quality controls and policy frameworks is paramount to evolving AI from a research-bound tool into a reliable diagnostic adjunct within standard pediatric care.
    Keywords:  Artificial intelligence; Early diagnosis; Machine learning; Pediatric intensive care unit; Precision medicine; Sepsis
    DOI:  https://doi.org/10.1007/s12519-026-01052-3
  35. Cureus. 2026 May;18(5): e108280
    Cholecystitis and Liver Abscess Caused by Oral Bacteria.
    Ryosuke Kikuchi, Tomohiro Suzuki, Yutaka Ejiri, Mayumi Tai, Ichii Osamu.
      The concept that oral foci of infection can have systemic effects is known as "oral focal infection." Here, we report two rare cases of hepatobiliary infections caused by oral bacteria: Porphyromonas gingivalis and Actinomyces naeslundii. Case 1 involved acute cholecystitis, whereas Case 2 presented with a liver abscess. Both patients had poor oral hygiene, suggesting hematogenous spread from the oral cavity. These cases underscore the potential for oral pathogens to cause systemic infections and highlight the importance of oral hygiene and interprofessional collaboration between medicine and dentistry for prevention.
    Keywords:  actinomyces naeslundii; cholecystitis; liver abscess; oral bacteria; porphyromonas gingivalis
    DOI:  https://doi.org/10.7759/cureus.108280
  36. NPJ Prim Care Respir Med. 2026 Jun 08.
    The European respiratory society guideline for adult bronchiectasis 2025: summary and implementation guide for primary care.
    Fiona Mosgrove, Janwillem Wh Kocks, Eliza Kompatsiari, Alan Timothy, Tanja Hedberg, Merete B Long, Stefano Aliberti, James D Chalmers.
      Bronchiectasis is a common chronic respiratory disease with rising prevalence, hospitalisation rates, and mortality. It is estimated to affect approximately 1 in 200 adults, imposing a substantial symptom burden and significant healthcare costs, largely driven by exacerbations. Although diagnosis and long-term management are usually led by respiratory specialists, most patient care interactions occur in primary care, including the management of multimorbidity and acute exacerbations. In December 2025, the European Respiratory Society (ERS) published updated global clinical practice guidelines for adult bronchiectasis. This article summarises the 2025 ERS recommendations with a specific focus on their implementation in primary care practice. Key priorities include improving early recognition and reducing diagnostic delay, undertaking standardised investigations to identify underlying causes and treatable traits, and recognising features associated with poor outcomes that warrant specialist referral. The guidance emphasises the importance of sputum microbiology, including testing for non-tuberculous mycobacteria, and targeted blood investigations such as immunoglobulins and allergic bronchopulmonary aspergillosis serology. Core management strategies relevant to primary care are reviewed, including airway clearance techniques, pulmonary rehabilitation, and evidence-based use of inhaled therapies. The article outlines best practice for the management of acute exacerbations, highlights differences from asthma and COPD care, and clarifies the limited role of inhaled corticosteroids in bronchiectasis. The identification and monitoring of patients who may benefit from long-term antibiotic therapy, including those with Pseudomonas aeruginosa infection, are also discussed. By translating specialist guideline recommendations into a primary care context, this summary aims to support timely diagnosis, optimise ongoing management, and improve outcomes for adults with bronchiectasis.
    DOI:  https://doi.org/10.1038/s41533-026-00528-z
  37. Int J Nurs Stud. 2026 Jun 02. pii: S0020-7489(26)00281-6. [Epub ahead of print]182 105609
    Digital platforms and shared decision-making tools for home wound care: An integrative review.
    Chunhong Yu, Melanie Murray, Ruth Wei, Vicki Cope.
       BACKGROUND: Wounds pose significant clinical and economic challenges, driven by ageing populations. Digital technologies, including telemedicine and mobile applications, offer remote wound assessment, monitoring, and treatment, improving outcomes and reducing costs while aiding patient involvement in decision-making. Alongside these technologies, shared decision-making tools, have been used to engage patients and caregivers in selecting appropriate care strategies based on evidence and personal preferences, highlighting their roles in supporting patient and caregiver engagement.
    AIMS: This review aims to summarise and critique literature on the use of digital platforms and shared decision-making tools by patients and families for home-based wound care.
    METHODS: This review was guided by Whittemore and Knafl's methodology for integrative review, focusing on digital platforms and shared decision-making tools for home-based wound care. A comprehensive database search was conducted in June and October 2024, and repeated in December 2025, covering both English-language (Web of Science, CINAHL, Cochrane, PsycINFO, Ovid Emcare) and Chinese-language databases (CNKI, VIP, Wan Fang). Searches included English and Chinese journal articles with no publication date restrictions. Eligible studies were full-text, peer-reviewed, published in English or Chinese, and focused on home wound care using digital platforms or shared decision-making tools. Exclusions included conference abstracts, opinion pieces, case studies, and low-quality studies, assessed using Joanna Briggs Institute critical appraisal tools.
    RESULTS: This review included 35 articles covering studies from multiple countries. The methods included randomised-controlled trials, quasi-experimental studies, qualitative studies, cohort studies, and cross-sectional studies. Three types of digital tools applied to the management of these wound types and included the Internet of Things, specially designed applications, and social media. Digital tools are used for wound management, patient education, and remote consultation, with the clinical outcomes evaluated to include wound healing time, pain, recurrence, and hospitalisation rate. The included studies reviewed used a variety of tools to evaluate the effectiveness of the intervention, such as wound assessment scales and quality of life scales, as well as exploring the impact of digital tools on costs and self-efficacy. Only two specifically addressed shared decision-making in home-based wound care.
    CONCLUSIONS: This review highlights the diverse ways digital and shared decision-making tools, ranging from Internet of Things devices to mobile apps and social media platforms, are supporting wound care, particularly in home settings. These tools not only assist with wound monitoring and education but also facilitate shared decision-making, helping caregivers better manage patient care.
    STUDY REGISTRATION: Review protocol not registered, which is consistent with current recommendations for integrative reviews.
    Keywords:  Decision-making; Digital platform; Home care; Integrative review; Wound management
    DOI:  https://doi.org/10.1016/j.ijnurstu.2026.105609
  38. Microbiologyopen. 2026 Jun;15(3): e70329
    Phylogenetic Profiling of the Diabetic Foot Ulcer Microbiome of an Afro-Caribbean Population.
    Nkemcho Ojeh, Bidyut R Mohapatra, Margaret O'Shea, Dale Springer, Judy Ward, Mohmmed Sallu, Natacha Paquette, Keith Gooding, Anna Springer, O Peter Adams.
      Diabetic foot ulcers (DFUs) are associated with high morbidity, amputation rates, and healthcare costs in Barbados. This pilot study compares the microbiome diversity of chronic DFUs and paired normal skin (controls) from biopsies in Afro-Caribbean patients with type 2 diabetes using Illumina amplicon sequencing targeting the 16S ribosomal RNA (rRNA) gene and the internal transcribed spacer 2 (ITS2) region. Both DFUs and controls harbored diverse bacterial and fungal communities, with differences in taxonomic composition and relative abundance profiles. The dominant bacterial genera were Corynebacterium (18.3% in DFUs, 24.3% in controls) and Staphylococcus (14.9% in DFUs, 14.1% in controls). The dominant bacterial species was Corynebacterium striatum (17.3% in DFUs, 23.8% in controls) followed by Pseudomonas aeruginosa in DFUs (8.9%) and Staphylococcus aureus in controls (13.3%). The dominant fungal genera was Densospora (12% in DFUs, 12.6% in controls). The dominant fungal species was Rhodotorula graminis in DFUs (6.18%) and Paracamarosporium leucadendri in controls (3.85%). Candida duobushaemulonii, with intrinsic resistance to antifungal agents, was detected with higher relative abundance in DFUs than in controls (4.44% vs. 2.36%). Fungal Shannon alpha diversity was significantly reduced in DFUs (p = 0.039), while beta diversity did not differ between groups for bacteria (p = 0.982) or fungi (p = 0.975). The differences in taxonomic composition and relative abundance profiles, and co-occurrence of clinically relevant bacterial and fungal taxa, highlight the potential role of polymicrobial communities in DFU chronicity in the Afro-Caribbean cohort studied, and supports future studies to evaluate implications for antimicrobial stewardship.
    Keywords:  diabetic foot ulcer; fungi; microbial communities; microbiome; next‐generation sequencing; wound healing
    DOI:  https://doi.org/10.1002/mbo3.70329
  39. Cells. 2026 Jun 04. pii: 1034. [Epub ahead of print]15(11):
    Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Dysfunction in Human Diseases: Molecular Mechanisms and Pathophysiological Implications.
    Md Sohanur Rahman, Mohammed Daira.
      Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) dysfunction is increasingly recognized as a key contributor to a broad spectrum of human diseases beyond classical cystic fibrosis (CF). CFTR is a cAMP-regulated chloride and bicarbonate ion channel expressed in both epithelial and non-epithelial tissues, where it regulates ion homeostasis, mucosal hydration, and cellular signaling. Both inherited CFTR mutations and acquired dysfunction resulting from environmental or inflammatory factors can disrupt these physiological processes and drive disease progression. Current evidence linking CFTR dysregulation to respiratory diseases, such as cystic fibrosis, chronic obstructive pulmonary disease (COPD), asthma, and HIV-associated airway disease, as well as cardiovascular, renal, neurological diseases, and cancer, is comprehensively discussed. Mechanistically, impaired CFTR function promotes oxidative stress, chronic inflammation, epithelial barrier dysfunction, altered mucociliary clearance, and dysregulation of signaling pathways, including NF-κB, TGF-β, PI3K/Akt, MAPK, and Wnt/β-catenin. In the context of HIV infection and cigarette smoke exposure, CFTR suppression is mediated in part by TGF-β signaling and miRNA-dependent mechanisms, resulting in compromised airway defense and increased susceptibility to pulmonary complications. Recent studies further demonstrate that CFTR dysregulation alters the expression of genes involved in fibrosis, inflammation, angiogenesis, and epithelial-mesenchymal transition (EMT). Notably, CFTR may act as either a tumor suppressor or a context-dependent oncogene, depending on tissue type and signaling milieu, highlighting its complex role in cancer biology. Advances in CFTR-targeted therapies, including potentiators, correctors, gene therapy, and combination approaches, have markedly improved outcomes in CF and may offer therapeutic potential for diseases associated with acquired CFTR dysfunction. We summarize the systemic consequences of CFTR dysregulation and the need for further mechanistic and translational research to clarify its role across diverse human diseases.
    Keywords:  CFTR; gene; human diseases; respiratory system
    DOI:  https://doi.org/10.3390/cells15111034
  40. bioRxiv. 2026 Jun 03. pii: 2026.06.02.729646. [Epub ahead of print]
    Site-specialization of human oral Porphyromonas species.
    Julian Torres-Morales, Floyd Dewhirst, Kathryn M Kauffman, Jessica Mark Welch, Gary Borisy.
      Site-specificity within the human oral cavity reflects adaptation mechanisms such as genome divergence and metabolic specialization. Members of the genus Porphyromonas are distributed across oral sites in health and disease, yet the specific distribution of taxa and the functional basis of their site-specificity remain poorly understood. We analyzed 1,242 metagenomes from nine oral sites in healthy individuals and 24 subgingival plaque samples from individuals with periodontitis. Competitive mapping to a dereplicated genus-level pangenome of 84 reference genomes, combined with phylogenomic, gene-level detection, and functional profiling, revealed distinct site-specific distribution patterns, ecotype differentiation, and metabolic specialization across Porphyromonas taxa. Porphyromonas pasteri was the most abundant and widespread taxon in healthy subjects, comprising two ecotypes--one mucosal, one plaque-associated. Porphyromonas gingivalis was rare in healthy subjects but present in periodontal disease, although detected in only half of periodontitis samples. P. gingivalis exhibited the broadest metabolic repertoire, suggestive of a survival strategy adaptive to disparate conditions. In contrast, Porphyromonas catoniae, restricted to healthy dental plaque, lacked biosynthetic pathways for cobalamin, biotin, and serine, implying nutritional dependency on other taxa or the host. Porphyromonas endodontalis, detected in subgingival plaque across both health and disease, also lacked several metabolic pathways. A 44 kb conjugative element identified in P. gingivalis was detected across healthy and periodontitis subgingival plaque microbiomes independently of the P. gingivalis chromosome, indicating horizontal transfer. These findings reveal genomic divergence and complex metabolic specialization among Porphyromonas taxa, refining our understanding of their role in the ecological structure of the human oral microbiome.
    DOI:  https://doi.org/10.64898/2026.06.02.729646
  41. Int Wound J. 2026 Jun;23(6): e70972
    Diabetes and Delayed Wound Healing: Molecular Mechanisms and Dermatological Interventions.
    Sasha Jreije, Marwan Fadel, Carl Karam, Hilda E Ghadieh, Antoine Ghanem.
      Diabetes mellitus is a global burden that affects wound healing at nearly every stage, transforming what should be a coordinated and self-limited repair process into a chronic, non-healing state. In diabetic patients, sustained hyperglycemia drives persistent inflammation, impaired angiogenesis, fibroblast dysfunction and extracellular matrix instability, resulting in refractory ulcers and often causing severe complications such as infection, hospitalisation, amputation and premature death. This review integrates mechanistic insights with dermatological advancements providing a comprehensive picture of diabetic wound pathophysiology and emerging therapeutic approaches. The normal sequence of wound healing is outlined and contrasted with the cellular and molecular derailments seen in diabetes, with a focus on macrophage polarisation, neutrophil dysfunction, mast cell and dendritic cell dysregulation, impaired regulatory T cell function, pericyte loss, disrupted neuroimmunomodulation, oxidative stress and defective tissue remodelling. Current and novel interventions including hyperbaric oxygen therapy, negative pressure wound therapy, advanced dressings, biologic grafts, phototherapy, as well as regenerative strategies involving stem cells, nanomaterials and exosome-based treatments are critically examined for their clinical utility, limitations and translational promise. No single modality fully addresses the multifactorial nature of diabetic wounds, but multimodal, mechanism-driven strategies hold potential to synergistically restore tissue repair. Bridging basic science with innovative dermatological interventions remains essential to reduce the global burden of diabetic wounds and improving quality of life for diabetics.
    Keywords:  diabetes mellitus; diabetic ulcers; regenerative medicine; therapeutics; wound healing
    DOI:  https://doi.org/10.1111/iwj.70972
  42. J Infect Public Health. 2026 Jun 05. pii: S1876-0341(26)00154-1. [Epub ahead of print]19(8): 103282
    Epidemiology, antimicrobial resistance patterns, management, and predictors of mortality in diabetic foot infections in a Lebanese hospital: A retrospective observational study.
    Aya Ali Ahmad, Elie Sokhn, Carole Dib, Patricia Shuhaiber, Mohamed Issa, Rania Itani.
       BACKGROUND: Diabetic foot infections (DFIs) are a common and serious complication of type II diabetes mellitus, contributing to morbidity and mortality. Their management is often complicated by its etiology, antimicrobial resistance, and treatment practices. In Lebanon, recent epidemiological data and local treatment guidelines remain limited. This study aimed to investigate the antimicrobial susceptibility of DFIs, evaluate the appropriateness of initial therapy, and identify predictors of mortality.
    METHODS: This retrospective observational study included hospitalized patients with confirmed DFIs at a tertiary care university hospital in Beirut, Lebanon. Medical records from 2020 to 2025 were reviewed. Kaplan-Meier survival and multivariable logistic regression analyses were conducted to identify predictors of mortality.
    RESULTS: Out of 343 DFI cases, 160 patients were included. Most infections were community-acquired (145, 90.6%), and nearly half were of moderate severity (49.4%). Gram-negative bacteria predominated (70.4%), mainly Pseudomonas aeruginosa. The prevalence of MRSA among Staphylococcus aureus was 43.2%. Nearly one-third received inappropriate initial antimicrobial therapy (32.5%). The 60-day mortality was 11.9%. Higher Charlson Comorbidity Index (CCI) (Adjusted Odds Ratio [AOR] = 1.77, P = 0.001) and severe infection (PEDIS grade 4; AOR = 10.05, P = 0.001) were independently associated with increased mortality, whereas surgical management was associated with significantly reduced odds of death (AOR = 0.13, P = 0.02).
    CONCLUSION: In Lebanon, DFIs are mainly caused by Gram-negative pathogens, with notable MRSA prevalence, and frequently managed with inappropriate initial antimicrobial therapy. Increased comorbidity burden and severe infection independently predict higher 60-day mortality, whereas timely surgical management is associated with a significant reduction in death. These findings highlight critical gaps in current practice and emphasize the need for strengthened antimicrobial stewardship, early risk stratification, and timely, targeted therapeutic and surgical management to improve patient outcomes.
    Keywords:  Antibiotics; Diabetic foot infections; Epidemiology; Lebanon; Mortality; Multidrug-resistant organisms
    DOI:  https://doi.org/10.1016/j.jiph.2026.103282
  43. Bioinformation. 2026 ;22(4): 2470-2475
    Personalized dentistry: Enhancing outcomes through patient-centered innovation.
    Aarushi Sharma, Anjali Tuteja, Mili Patel, Huma Tahir, Akash Daddanala, Aditi Pustake.
      Current dental practice relies on generalized treatment protocols that inadequately address individual genetic, biological and environmental variation, limiting precision in the prevention and management of oral and craniofacial diseases. Intricate interactions among these factors drive disease development, highlighting the need for more individualized approaches. Dentistry is moving toward personalized care through advances in digital technologies, salivary diagnostics and genomics. Therefore, it is of interest to describe the development and reach of personalized dentistry, with a focus on customized prevention and treatment based on genetic, lifestyle and clinical factors. With the use of biomarkers and patient-specific data, conditions such as caries and periodontal disease can be diagnosed earlier and managed more precisely. While these innovations promise better outcomes, challenges remain in ensuring data privacy and affordability.
    Keywords:  Personalized dentistry; artificial intelligence (AI); genomics; precision oral health care; salivary biomarker
    DOI:  https://doi.org/10.6026/973206300222470
  44. Crit Care. 2026 Jun 11.
    Computational tools for personalizing treatment of acute respiratory failure, from machine learning to digital twins: a narrative review.
    Sina Saffaran, Hang Yu, Hossein Shamohammadi, Liam Weaver, William Joy, Lauren Ketteridge, Beatrice Albanese, Lukasz Regulski, Simon Becker, Don Sharkey, T'ng Chang Kwok, Jonathan G Hardman, Nadir Yehya, Tommaso Mauri, Timothy E Scott, Roberto Tonelli, Enrico Clini, John G Laffey, Luigi Camporota, Declan G Bates.
      Patient-specific computational tools hold great promise for the development of more personalized treatment strategies for acute respiratory failure. Such tools span a continuum from data-driven predictors, to patient-specific mechanistic models, and ultimately to fully realized digital twins with continuous bidirectional model-patient interactions. Data-driven prediction models apply machine learning to large-scale patient datasets to develop tools that can help clinicians identify patients who are likely, or unlikely, to benefit from a particular course of treatment. By incorporating detailed computational representations of disease pathophysiology, patient-specific mechanistic models can provide insights into the effects of existing or novel treatment strategies, support patient stratification and treatment personalization, and enable the design of in silico clinical trials of new interventions. Finally, fully realized dynamic digital twins of patients could provide real-time decision support and 'simulate-before-treat' capabilities at the bedside, helping clinicians optimize treatment as the patient's disease state evolves. This narrative review provides an overview of recent research applying these approaches in the context of acute respiratory failure, encompassing both respiratory and ventilatory support across neonatal, paediatric and adult populations, and pre-hospital, ward and intensive care environments.
    Keywords:  Acute respiratory failure; Computational modelling; Decision-support systems; Digital twins; Machine learning; Respiratory support, mechanical ventilation
    DOI:  https://doi.org/10.1186/s13054-026-06079-6
  45. Int Wound J. 2026 Jun;23(6): e70967
    High Adherence to Remote Monitoring Technology in Patients at Risk for Diabetic Foot Ulcer.
    Kaishi Yang, Gary Rothenberg, Laura Rincon, Raul Lopez Fanas, Alyson K Myers, Denise Levy, Johanna P Daily.
      Globally, a lower-extremity amputation occurs every 20 s as a complication of a diabetic foot ulcer, underscoring the urgent need for effective preventive strategies. Previous studies have shown that temperature-based foot monitoring can reduce both the incidence and severity of diabetic foot ulcers. However, real-world adherence data for remote temperature monitoring remain limited, particularly in diverse or resource-constrained communities. We conducted a pilot implementation study of 20 adults with diabetes and a history of diabetic foot ulcers to assess adherence to a remote foot temperature monitoring mat within the context of receiving podiatric care. Participants are instructed to stand on the mat for 20 s daily, and data are transmitted wirelessly for remote monitoring. Adherence was defined as use of the mat at least four times a week. Participants demonstrated high adherence to the foot monitoring mat, averaging 6 scans per week, with sustained adherence over the 6-month study period. These findings suggest that high-risk patients with diabetes can reliably engage with the foot temperature monitoring technology, supporting its potential as a management tool to improve outcomes and reduce the burden of diabetic foot ulcer-related complications in high-risk, resource constrained patient populations.
    Keywords:  chronic wounds; diabetes; diabetic complications; diabetic foot ulcer; prevention; remote temperature monitoring technology
    DOI:  https://doi.org/10.1111/iwj.70967
  46. J Wound Care. 2026 May;35(5A): S1-S40
    International guideline on antimicrobial stewardship and the role of microbial-binding dressings in wound care 2026: infection prevention, control, early intervention and treatment.
    Patricia Idensohn, Emma Woodmansey, Febe Bruwer, Windy Cole, Bodo Günther, Klarida Hoxha, Vivek Lakshmanan, Astrid Probst, Paulo Ramos, George Smith, Zhavandre van der Merwe, Kevin Woo, Samantha Holloway, Kirsi Isoherranen, Prashini Moodley, Biagio Nicolosi, Sebastian Probst.
       BACKGROUND: Wound microbial burden and infection can delay wound healing, increase complications and rapidly progress to spreading or systemic infection, particularly in high-risk patients. Early diagnosis and appropriate treatment are essential for improved outcomes and reduced antimicrobial resistance (AMR). AMR is a growing concern in wound care due to reported inappropriate use of topical antiseptics, as well as systemic antibiotics. A recent survey found 41.8% of healthcare professionals used antimicrobial prophylactically, against recommendations, while 37.2% did not follow antimicrobial stewardship (AMS) guidance, indicating a potential gap in best-practice treatment.
    AIMS: The primary aim of this document was to provide evidence-based guidance on the role of microbial-binding dressings (MBDs) in managing microbial burden, preventing infection and reducing the need for antimicrobial intervention in both surgical incisions and hard-to-heal wounds. The secondary aim was to summarise key findings in four clinical pathways.
    METHODS: This guideline was developed according to AGREE II with a pragmatic literature review with GRADE assessments and a modified Delphi process for developing evidence-based statements. The literature search asked: 'In adults with a wound or surgical incision, do MBDs, compared with standard care, reduce surgical site infections, microbial burden, signs of infection, antibiotic use, antiseptic dressing use, time to healing or complication rates?'. For the statements, a 10-member expert panel scored agreement from 1 to 5, over three rounds (two remote and one in person), with acceptance at a mean score of ≥4.00 (SD ≤1.00).
    RESULTS: The literature review returned 12 studies on surgical incisions and 17 on hard-to-heal wounds, varying in evidence level and certainty. From 13 original statements, strong agreement was reached for 14; nine in round one, two in round two and three in round three (in-person meeting), with one statement split into two prior to agreement. The statements fit three themes: challenges of wound infection and AMR; benefits of MBDs for infection prevention and control (IPC); and early IPC in future AMS strategies. The guideline presents each statement with supporting evidence and detailed guidance for implementation in practice. This is followed by four easy-to-use AMS clinical pathways to support practical implementation, decision-making and consistency in care, currently under evaluation, with further validation studies expected.
    CONCLUSION: This guideline identifies and aims to meet a clear need for evidence-based best practice to enhance AMS in wound care. A paradigm shift towards infection prevention, early intervention and first-line treatment using MBDs should be considered an opportunity in everyday practice to minimise progression of infection, limit antimicrobial requirements and thus tackle the global threat of AMR.
    Keywords:  Antimicrobial stewardship; early intervention; infection prevention and control; microbial-binding dressings; surgical and hard-to-heal wounds; wound care; wound infection prevention and management
    DOI:  https://doi.org/10.12968/jowc.2026.0302
  47. J Burn Care Res. 2026 Jun 07. pii: irag090. [Epub ahead of print]
    Artificial Intelligence in Burn and Wound Care: Image Analysis, Prediction, and Clinical Integration.
    Joshua Khorsandi, Jason Mirharooni, Justin Kahen, Ezzah Tariq, Michael Harouni, Demitri Franzoni, Joshua MacDavid.
      Burn injuries and chronic wounds impose a substantial and growing global health and economic burden, particularly in low- and middle-income countries and among aging populations with diabetes, vascular disease, and immobility. Conventional wound assessment depends heavily on visual inspection, manual measurements, and clinician experience, leading to variability in burn-depth estimation, wound sizing, and prognostication. Artificial intelligence, especially deep learning-based computer vision, has emerged as a promising approach to provide objective, reproducible, and scalable evaluation of burns and complex wounds. In this narrative review, we synthesize studies published between 2015 and 2025 focused on three domains: image-based wound recognition and segmentation, predictive modeling of outcomes such as healing, graft success, infection, and amputation, and integration of artificial intelligence into telemedicine platforms and smart technologies for remote monitoring. Across multiple datasets, convolutional neural networks achieve segmentation Dice coefficients frequently exceeding 0.85 and burn-depth or tissue-type classification sensitivities above 0.90, while multimodal prediction models reach accuracies and areas under the receiver operating characteristic curve of approximately 0.80-0.95. Early clinical pilots demonstrate the feasibility of embedding artificial intelligence tools into smartphone applications, telehealth workflows, and sensor-enabled dressings. Nonetheless, persistent challenges related to algorithmic bias across skin tones, limited dataset diversity, opaque model behavior, workflow integration, and evolving regulatory frameworks must be addressed before artificial intelligence-enabled wound care systems can be safely and equitably deployed at scale.
    Keywords:  Artificial intelligence; burn depth assessment; digital health; predictive modeling; wound image analysis
    DOI:  https://doi.org/10.1093/jbcr/irag090
  48. Diabetologia. 2026 Jun 09.
    Unravelling the developmental origins of cystic fibrosis-related diabetes.
    Alex Cho, Maria Cristina Nostro.
      Cystic fibrosis (CF)-related diabetes (CFRD) is a growing and evolving concern for people living with cystic fibrosis. As its own unique clinical entity, there is an urgent need to better understand this complex health challenge to improve the quality of life for people with CF. Unfortunately, many aspects of CFRD pathophysiology and pathogenesis remain unclear, resulting in a disparity in the standard of care provided. An emerging body of evidence supports that CFRD may have developmental origins, as people with CF present with pancreatic pathology and glucose abnormalities as early as in utero. This therefore suggests that the CF transmembrane conductance regulator (CFTR) gene mutations that cause CF may impair pancreatic organogenesis, thus leading to CFRD. This review consequently aims to summarise the existing evidence that may support a fundamentally vital role of CFTR in the development of the pancreas. From aspects of the endocrine and exocrine pancreas to scrutinising the broader islet microenvironment, the many constituents at play in pancreatic organogenesis are highlighted. Unravelling the deeper complexities of CFRD pathogenesis will not only clarify existing knowledge gaps but may transform the way future care is provided.
    Keywords:  Cystic fibrosis; Cystic fibrosis transmembrane conductance regulator; Cystic fibrosis-related diabetes; Development; Microenvironment; Organogenesis; Pancreas; Review
    DOI:  https://doi.org/10.1007/s00125-026-06768-5
  49. Infect Dis Ther. 2026 Jun 11.
    Infections in Burn Patients: Pathophysiology, Prevention, and Contemporary Therapeutic Strategies in the Era of Antimicrobial Resistance.
    Ana Cătălina Țânțu, Monica Marilena Țânțu, Corneliu Ovidiu Vrancianu, Andreea-Mihaela Sandu, Roxana-Elena Cristian, Marian Constantin, Alina Păunescu, Daniel Diaconescu, Elena Rodica Dragu, Mădălina Olivia Adameșteanu, Bogdan Chioaru, Sorin Cristian Hariga, Cristian Radu Jecan, Ionică Daniel Vîlcea.
      Burn injuries are associated with significant morbidity and mortality, largely driven by infectious complications. Disruption of the skin barrier, systemic inflammation, and postburn immunosuppression promote microbial colonization and progression to local and systemic infections, a challenge further exacerbated by the increasing prevalence of multidrug-resistant organisms (MDRO). Patients with extensive burns, inhalation injury, prolonged hospitalization, and invasive device use are particularly vulnerable. The microbiological profile of burn wound infections evolves dynamically, shifting from early Gram-positive predominance to Gram-negative and multidrug-resistant (MDR) pathogens, including members of the ESKAPE group, in later stages. Effective management, therefore, requires an integrated approach combining early surgical intervention, strict infection control measures, continuous microbiological surveillance, and targeted antimicrobial therapy. This narrative review synthesizes current evidence on the pathophysiology, risk factors, and microbiological dynamics of burn-associated infections, alongside contemporary prevention and treatment strategies, including topical therapies, advanced biomaterials, systemic antibiotic approaches, and antimicrobial stewardship. Emerging strategies such as nanoparticle-based systems and artificial intelligence-driven predictive models highlight a shift toward precision medicine in burn care; however, their clinical translation remains limited by insufficient validation and standardization. In conclusion, optimizing outcomes in burn-associated infections will depend on integrating evidence-based clinical practices with innovative technologies, while reinforcing antimicrobial stewardship and developing validated predictive tools to address the growing burden of antimicrobial resistance.
    Keywords:  Antimicrobial resistance; Burn patient care; Burn wound infection; Burns; ESKAPE pathogens; Infection prevention
    DOI:  https://doi.org/10.1007/s40121-026-01376-7
  50. Otol Neurotol. 2026 Jun 12.
    A Systematic Review and Quality Assessment of Clinical Practice Guidelines for Otitis Externa to Support the WHO Package of Ear and Hearing Care Interventions.
    Lauren K Dillard, Pallavi Mishra, Chitra Chander Shekhar, Svetlana Chibisova, Ioannis Hannadjas, Anjola Onifade, Omar Sajjad, George Tavartkiladze, Carolina Der, Shelly Chadha.
       OBJECTIVE: This systematic review of clinical practice guidelines summarizes key recommendations and interventions related to the prevention, diagnosis, and management of acute otitis externa. The interventions identified in this review will contribute to the development of the World Health Organization (WHO) Package of Ear and Hearing Care Interventions (PEHCI).
    DATABASES REVIEWED: We searched PubMed, CINAHL, Clinical Key, and TRIP databases to identify clinical practice guidelines related to otitis externa. We hand-searched professional organization websites to identify additional clinical practice guidelines that were not identified from the database search or that were published in languages other than English (Spanish, French, Chinese, and Russian).
    METHODS: Publications were required to be clinical practice guidelines and published between 2014 and 2024. All review processes were performed by 2 independent reviewers, including the quality assessment with the AGREE II tool.
    RESULTS: We identified 6 clinical practice guidelines, 4 of which met our prespecified inclusion criteria based on the AGREE II assessment. The 4 included guidelines were published in the United States, Colombia, and 2 in Russia, and in 3 languages. Key interventions focused on prevention (avoiding injury, keeping the ear canal dry, and timely cerumen management), patient education and counseling, comprehensive diagnostic assessment, and pharmaceutical interventions and ear cleaning.
    CONCLUSION: The clinical practice guidelines identified key interventions related to the prevention, diagnosis, and management of otitis externa. These interventions will be used to inform the development of the PEHCI, which will identify priority ear and hearing care interventions that can be integrated into national health services packages and policies.
    Keywords:  Audiology; Clinical Practice Guidelines; Otitis Externa; Otolaryngology
    DOI:  https://doi.org/10.1097/MAO.0000000000004972
  51. Curr Opin Microbiol. 2026 Jun 09. pii: S1369-5274(26)00070-6. [Epub ahead of print]92 102776
    Multispecies biofilms are hubs for metabolic interactions leading to ecologically and biotechnologically relevant emergent properties.
    Maximilian L Flaig, Cristina I Amador, Mette Burmølle.
      In nature, the majority of bacteria live in structured communities, called biofilms. The biofilm environment gives rise to community-intrinsic and biofilm-associated emergent properties. Through interactions between the indwelling bacteria, the biofilm and its environment, different matrix components, as well as interactions between the bacteria and the EPS matrix, the biofilm environment provides distinct environmental and ecological niches for its inhabitants. Through the creation of subniches within the biofilm environment, multispecies biofilms represent highly heterogeneous ecosystems. Here, we discuss how multispecies biofilms can host and reinforce a variety of different metabolic interactions and, conversely, how metabolic interactions shape community properties and functionality. We provide examples on how co-metabolism and cross-feeding of metabolites, as well as sharing of resources and other public goods, can facilitate the coexistence of different species, while competition for resources, as well as other direct or indirect forms of competition, can result in the exclusion of others. We also outline how the metabolic interactions within multispecies biofilms can give rise to novel phenotypes and emergent properties that may be useful for applications in biotechnology and the bioremediation of polluted ecosystems.
    DOI:  https://doi.org/10.1016/j.mib.2026.102776
  52. Front Pediatr. 2026 ;14 1737211
    Mycobacterium abscessus infection in a young man with cystic fibrosis: a case report and literature review.
    Ling Luo, Zhuoyao Guo, Weicheng Chen, Yanghong Zheng, Chen Chen, Qiang Li, Na Wang, Yingqun Ji, Jing Hua.
       Background: Cystic fibrosis (CF) is a rare autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Although relatively common in Caucasian populations, CF is rare in China, where it frequently presents with non-specific respiratory symptoms, leading to delayed diagnosis and frequent coinfections with multidrug-resistant pathogens.
    Case report: A 21-year-old man presented with a 6-year history of recurrent productive cough and intermittent fever over the past 6 months. Imaging revealed bronchiectasis with evidence of infection. Metagenomic next-generation sequencing of bronchoalveolar lavage fluid identified Staphylococcus aureus and Mycobacterium abscessus. Further investigations revealed pancreatic lipomatosis, congenital absence of seminal vesicles, and fat-soluble vitamin deficiencies. CF diagnosis was confirmed by elevated sweat chloride concentration (88 mmol/L) and biallelic CFTR mutations. Clinical stability was achieved through a quadruple antimycobacterial regimen (linezolid, moxifloxacin, azithromycin, and minocycline) combined with systemic supportive care. CFTR modulator therapy was deferred due to limited access and financial constraints.
    Conclusion: We report a case of CF in a Chinese patient presenting with nontuberculous mycobacterial infection, a condition rarely documented in East Asian populations. We provide a review of the relevant literature, aiming to emphasize the importance of early recognition of CF, personalized antimicrobial strategies, and improved access to essential medications.
    Keywords:  CFTR gene; CFTR modulators; Mycobacterium abscessus; bronchiectasis; case report; cystic fibrosis; nontuberculous mycobacteria
    DOI:  https://doi.org/10.3389/fped.2026.1737211
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