bims-fagtap Biomed News
on Phage therapies and applications
Issue of 2026–08–16
sixty-five papers selected by
Luca Bolliger, lxBio
  1. Pharmacology of Bacteriophage Therapy in Children: A Re-Emerging Paradigm in Antibacterial Therapy.
  2. Harnessing phages in the age of antibiotic resistance: immunological perspectives.
  3. Bacteriophage-Based Therapeutic, Diagnostic, and Biocontrol Platforms: Engineering, Evidence, and Translational Challenges.
  4. Policy in practice: Cystic Fibrosis Australia and Phage Australia surveys: understanding clinical needs and attitudes towards phage therapy in the cystic fibrosis community.
  5. Isolation and characterisation of novel lytic bacteriophages for therapeutic applications in biofilm-associated prosthetic joint infections.
  6. Dental wastewater reveals a hidden reservoir of oral bacteriophage diversity.
  7. Letter: Beyond the Petri Dish: Why Phage Therapy Has yet to Reach Routine Clinical Practice.
  8. Evaluation of a phage-inclusive multimodal strategy for recurrent urinary tract infections.
  9. Bacteriophage-mediated biofilm control: a novel targeted strategy for the management of dental caries.
  10. Antimicrobial resistance mechanisms, treatment challenges, and emerging strategies in Stenotrophomonas maltophilia infections.
  11. Exploring perceptions of bacteriophage use in the UK across the One Health spectrum: a roundtable discussion.
  12. Characterization of Enterococcus faecium-Targeting Minhovirus Bacteriophages.
  13. Vaginal Microbiota Dysbiosis and Infections: A Comprehensive Review of Microbial and Therapeutic Perspectives.
  14. EARLY HUMORAL IMMUNE RESPONSES TO BACTERIOPHAGES AND SHORT-COURSE PHAGE THERAPY OUTCOMES IN PATIENTS WITH URINARY TRACT INFECTIONS.
  15. Nonliving biotherapeutics for veterinary enteric disease: Postbiotics, bacteriophage, and antivirulence strategies to reduce antibiotic dependence.
  16. Isolation, characterization, and alginate hydrogel delivery of a Klebsiella aerogenes bacteriophage and its impact on biofilm degradation.
  17. Non-Drug therapeutic strategies to combat antimicrobial resistance in livestock: a review.
  18. Effects of Non-Surgical Periodontal Therapy on Dental Plaque Microbiome.
  19. First-in-Human Adjunctive Bacteriophage Therapy for Malakoplakia.
  20. Shotgun Metagenomic Analysis Reveals Taxonomic and Functional Transitions in the Salivary Microbiome During Periodontal Disease Progression.
  21. Unraveling Resistance and Thresholds in Phage Therapy Using In Vitro Staphylococcus aureus experiments and Pharmacokinetic/Pharmacodynamic Models.
  22. The impact of organ transplantation on changes in the oral microbiome, particularly on bacteria causing periodontal inflammation - narrative review.
  23. Crosstalk between salivary citrullinated proteins and oral health status in patients with rheumatoid arthritis: A cross-sectional study.
  24. Rubia cordifolia as an antimicrobial agent against periodontal pathogens - An in vitro microbiological study.
  25. Late-Onset Neonatal Sepsis: Contemporary Epidemiology, Diagnosis, Prevention, and Precision Therapeutics.
  26. Exploring the mechanism underlying negative pressure wound therapy in promoting the healing of diabetic foot ulcers via integrated multi-omics and bioinformatics approaches.
  27. Actinobacillus pleuropneumoniae - today's perspective on advances and challenges (2017- 2026).
  28. In vitro bactericidal activity of retainer/denture-cleaning formulations against planktonic populations of Pseudomonas aeruginosa and other common bacterial pathogens in cystic fibrosis.
  29. Enzyme-driven antimicrobial resistance and advancements in sustainable anti-infective strategies.
  30. Advances in antibiofilm strategies for medical implant-associated infections: emerging technologies and translational challenges.
  31. Targeted Therapy for Restoring CFTR Activity: From Experimental to Clinical Features.
  32. Building a future for phage-based technologies-a thought leadership approach to accelerating progress in the UK.
  33. Chemically modified curcumin in periodontal therapy: a scoping review.
  34. Human relevant platforms for cutaneous wound healing research: current landscape, translational gaps, and emerging frontiers.
  35. ESKAPE pathogens: Emerging isolates in odontogenic orofacial infections.
  36. Managing chronic wounds with TLC-NOSF dressings: evidence from a prospective real-life patient cohort.
  37. Bacteriophage Cocktails for Combating Multidrug-Resistant Staphylococcus aureus Infections in Animals: A Comprehensive Review Across Pets, Livestock, and Wildlife.
  38. Adjunctive therapies added to standard of care for diabetic foot ulcers: a systematic review and network meta-analysis with pairwise comparisons.
  39. Bacterial outer membrane vesicles in oral diseases: from pathogenic mediators to theranostic platforms.
  40. Pharmacotherapeutic Evaluation of Topical Insulin Versus Medicinal Honey Dressing in the Management of Diabetic Foot Ulcers among Patients with Diabetes Mellitus: A Randomized Controlled Trial.
  41. Oral microbiome contribution in colorectal carcinogenesis: polymicrobial interactions and virulence determinants.
  42. Chinese expert consensus on wound repair of venous leg ulcers (2025 edition).
  43. Exploring nursing students' first clinical experiences with patients with hard-to-heal wounds in Türkiye: a focus group study.
  44. S-Nitrosothiols modulate Porphyromonas gingivalis virulence.
  45. Isolation and characterization of two phages infecting Acinetobacter baumannii and their effectiveness in treating BALB/c mice lung infections.
  46. Antibiotic resistance in Pseudomonas aeruginosa: mechanisms, diagnostic challenges, and omics-based diagnostic solutions.
  47. Salivary and Gingival Crevicular Fluid Extracellular Vesicles in Periodontal Diseases.
  48. Healing the Sole: Combining Natural Plant Extracts and Conventional Drugs in Wound Delivery Systems for Diabetic Foot Ulcer Treatment.
  49. Infectious Diseases Society of America 2026 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.
  50. Pathogen characteristics and pre-index clinical factors associated with multidrug-resistant organism infections in intensive care unit patients.
  51. From bedside queries to complex care: AI for decision-making in infectious diseases.
  52. Mechanistic insights into phage dynamics to overcome intracellular bacterial reservoirs in urinary tract infections.
  53. Clinically Relevant Altered Antibiotic Responses and Mechanisms of β-Lactam Sensitization of MRSA in Cystic Fibrosis Artificial Sputum.
  54. Strengthening global biosecurity for synthetic nucleic acid technology: from sequence screening to risk-based governance in the AI era.
  55. Characterization and Therapeutic Potential of a Novel Lytic Bacteriophage vB_Kp_H122 Targeting Multidrug-Resistant Hypervirulent Klebsiella pneumoniae of K57 Capsular Type.
  56. Independent Predictors of Major Limb Amputation: A Systematic Review and Meta-Analysis of Adjusted Risk Factors.
  57. F-Type Pyocin Versus Phage λ Tail: Conserved Hub, Divergent Fibers.
  58. Pathophysiological and immunological characterization of a murine excisional wound infection model for cutaneous Mycobacterium abscessus infection.
  59. Recent advance in multifunctional hydrogels for skin wound care: From material classification and fabrication to therapeutic mechanisms.
  60. Artificial intelligence research in journals indexed in the web of science "infectious diseases" category: a bibliometric analysis, 2016-2025.
  61. The Oral-Gut-Brain Axis in Pediatric Populations: The Implications of Oral Dysbiosis for Systemic Inflammation and Neuroinflammation.
  62. Genomic insights into efflux-mediated biofilm persistence and multidrug resistance in Achromobacter xylosoxidans from cystic fibrosis.
  63. Multivariate analysis of treatment choices, disease activity, comorbidities, and oral impairments in rheumatoid arthritis patients.
  64. Platelet-Rich Plasma Fibrin Glue Dressing Combined with a Novel Repairing Gel for Healing Recalcitrant Diabetic Foot Ulcers: Findings from an Exploratory Randomized Pilot Trial.
  65. Nasal Lavage IL-4 and IL-13 in Cystic Fibrosis-Related Chronic Rhinosinusitis: Associations With Disease Severity and Potential Implications for Targeted Therapies.
  1. J Pediatr Pharmacol Ther. 2026 Aug;31(4): 483-492
    Pharmacology of Bacteriophage Therapy in Children: A Re-Emerging Paradigm in Antibacterial Therapy.
    Jennifer Le, John S Bradley, Nanda Ramchandar.
      The rise of antibiotic-resistant bacteria has reignited global interest in bacteriophages as potential therapeutic agents. Bacteriophage (phage) therapy provides an alternative to conventional antibiotics to treat serious infections caused by multidrug-resistant pathogens. In this narrative review, we explore the pharmacokinetics (PK), pharmacodynamics (PD), and clinical use of phage therapy in pediatric populations. We conducted PubMed searches for relevant publications from 1959 to September 2025. In contrast to most drugs, phages are self-replicating in the presence of target bacteria, necessitating the use of non-linear, dynamic pharmacology models to integrate phage-bacteria interaction (which can fluctuate over time, based on the presence of susceptible bacteria), as well as host factors such as immune clearance of phages and traditional host mechanisms of clearance of invasive bacterial pathogens. Phages are primarily cleared through the reticuloendothelial system, particularly in the liver and spleen. Advantages of phage therapy over antibiotics include a promising safety profile, preservation of the child's own microbiome, and, compared with some antibiotics, enhanced penetration into biofilms. Our knowledge of the benefits and risks of phage therapy is limited largely to current pediatric case reports and case series. The clinical use spans a wide breadth of clinical infections, mostly involving poorly responsive infections caused by multidrug-resistant bacteria. Until robust, prospective PK-PD and clinical trial data become available to guide therapy, phage therapy should be administered under protocols with individualized dosing and rigorous safety monitoring. Clinical applications using standardized, evidence-based dosing regimens and outcome assessments require further evaluation.
    Keywords:  antimicrobial resistance; bacteriophage; children; multidrug-resistant infections; pediatric; phage; pharmacokinetics
    DOI:  https://doi.org/10.5863/JPPT-25-00151
  2. Front Immunol. 2026 ;17 1866625
    Harnessing phages in the age of antibiotic resistance: immunological perspectives.
    Tasnime A Abdo Ahmad, Dina Kabbara, Zahraa Shokor, Esber S Saba.
      The rapid rise of antimicrobial resistance (AMR) has renewed interest in bacteriophages as precision antibacterial agents that can selectively target pathogenic bacteria while limiting disruption of commensal microbiota. However, therapeutic phages are not immunologically inert. Phage particles, phage-derived nucleic acids, bacterial lysis products, and manufacturing impurities can interact with innate and adaptive immune pathways, influencing phage pharmacokinetics, tissue persistence, inflammatory responses, and treatment durability. Innate mechanisms such as complement activation, phagocyte uptake, pattern-recognition receptor signaling, and neutrophil-mediated antibacterial responses may either restrict phage bioavailability or support bacterial clearance. Adaptive immune responses, particularly anti-phage antibodies and serum neutralization, may become relevant during repeated or systemic administration, although available clinical evidence indicates that antibody development does not uniformly predict treatment failure. This review integrates mechanistic, translational, and clinical evidence on phage-immune interactions, distinguishing direct immune recognition of phage components from indirect immune activation mediated by bacteria and bacterial products. We also discuss immune-aware strategies, including phage selection, formulation, route optimization, product-quality control, and immune monitoring, to improve the development of phage therapies for multidrug-resistant bacterial infections.
    Keywords:  antimicrobial resistance; immunogenicity; immunomodulation; innate and adaptive immunities; neutralizing antibodies; phage engineering; phage therapy; phages
    DOI:  https://doi.org/10.3389/fimmu.2026.1866625
  3. Int J Mol Sci. 2026 Jul 24. pii: 6615. [Epub ahead of print]27(15):
    Bacteriophage-Based Therapeutic, Diagnostic, and Biocontrol Platforms: Engineering, Evidence, and Translational Challenges.
    Nan Chen, Yingli Yang, Yao Wang, Yao Yao, Caihong Zheng.
      Bacteriophages are being revisited as programmable platforms for therapy, diagnostics, and biocontrol. Their value, however, depends on the setting. Therapeutic phages must do more than lyse bacteria in vitro: they need to reach infection sites, persist long enough to act, reduce bacterial burden, and limit resistance under clinically relevant conditions. Diagnostic platforms are judged by another standard, including sensitivity, specificity, matrix tolerance, and stable signal readout. Food, agricultural, and environmental applications instead rely on formulation stability, host specificity, scalable delivery, and ecological safety. This review summarizes the biological and engineering principles that support phage-based platforms, and then evaluates therapeutic, diagnostic, and nonclinical uses through an application-specific evidence framework. For therapy, we focus on evidence hierarchy, active phage exposure, immune clearance, persistence, infection spread, and host-resistance-bypass phenotypes. Recent studies on high-persistence and hyper-aggressive phages suggest that dissemination, plaque expansion, and resistance-bypass behavior should be considered during early candidate selection. Phage cocktails, antibiotic combinations, and engineered phages remain useful, but they should be treated as adaptive strategies rather than universal solutions. Overall, phage technologies require validation frameworks that link biological function with manufacturing quality, regulatory feasibility, and meaningful clinical or environmental endpoints.
    Keywords:  antimicrobial resistance; bacteriophages; biocontrol; phage diagnostics; phage persistence; phage therapy; translational challenges
    DOI:  https://doi.org/10.3390/ijms27156615
  4. Sustain Microbiol. 2025 ;2(1): qvae036
    Policy in practice: Cystic Fibrosis Australia and Phage Australia surveys: understanding clinical needs and attitudes towards phage therapy in the cystic fibrosis community.
    Stephanie Lynch, Holly Sinclair, Ameneh Khatami, Nicki Mileham, Jessica C Sacher, Jan Zheng, Ruby C Y Lin, Jonathan Iredell.
      Cystic fibrosis (CF) is the most prevalent serious inherited disease in Australia, imposing significant health risks. CF is characterized by chronic lung inflammation and recurrent pulmonary infections that increase morbidity and premature mortality rates. The emergence of antimicrobial resistance (AMR) places further challenges on the treatment and management of CF, necessitating research into alternative strategies for treatment of bacterial infections. Bacteriophage therapy, involving bacterial-specific viruses, is a potential avenue for AMR infections in patients with CF. Existing literature supports the feasibility of phage therapy in CF but there has been a gap in investigating attitudes of the CF community including affected individuals and their caregivers, regarding phage therapy. Understanding perspectives and needs of the CF community is essential for successful implementation and acceptance of novel therapies including phage therapy. We conducted a survey that encompasses responses from 112 consumers from across Australia, comprising people living with CF (38.4%), parents of affected children (49.6%), carers (6.4%), and family members (3%). The findings showed a significant reliance on antibiotics with 51.4% requiring oral, 43.4% nebulized, and 11.4% intravenous antibiotics within the preceding 2 weeks. Respondents highlighted the availability of new treatments, duration of hospitalizations and costs associated with treatment as important priorities to address. Despite an awareness of phage therapy among 62.4% of respondents, 86.4% expressed interest in obtaining more information, primarily from medical staff (66.7%). Notably, 96.0% of respondents expressed willingness to participate in phage therapy trials. The results of this survey highlighted the CF community's strong interest in advanced therapeutic approaches, specifically phage therapy. The findings reveal a notable recognition and acceptance of phage therapy as a viable treatment option for pulmonary infections associated with CF. This study addresses UN Sustainable Development Goal 3: Good Health and Wellbeing by advancing knowledge on alternative therapeutic strategies for managing AMR in CF. By exploring community attitudes towards bacteriophage therapy, the research promotes informed development and implementation of innovative, targeted treatments for CF-associated infections. These findings support the sustainable management of AMR, fostering better health outcomes and reducing reliance on traditional antibiotics, thereby contributing to long-term health resilience.
    Keywords:  antimicrobial resistance (AMR); cystic fibrosis (CF); phage therapy
    DOI:  https://doi.org/10.1093/sumbio/qvae036
  5. Sustain Microbiol. 2024 Jan;1(1): qvae028
    Isolation and characterisation of novel lytic bacteriophages for therapeutic applications in biofilm-associated prosthetic joint infections.
    Nathan J Burton, Luís D R Melo, Michaël F D Tadesse, Bethany Pearce, Evangelos Vryonis, Antonia P Sagona.
      Prosthetic joint infections are devastating complications of joint arthroplasties. Without effective management, they can lead to limb amputation and even death. A significant proportion of these infections is caused by the primarily commensal Coagulase-negative Staphylococci pathogens, which form thick, antibiotic-resistant biofilms at the site of infection. Combinatorial therapy involving antibiotics and bacteriophages may represent a strategy to overcome resistance. Previous research indicates that as bacteria develop resistance to antibiotics, they often become more susceptible to bacteriophages. In this study, we produced a cocktail of novel bacteriophages and assessed their viability to eradicate nosocomial staphylococcal biofilms. Here, we used clinical isolates from prosthetic joint infections to isolate and identify four new bacteriophages from sewage effluent. These novel phages were characterized through electron microscopy and full genome sequencing. Subsequently, we combined them into a phage cocktail, which effectively re-sensitized biofilms to vancomycin and flucloxacillin. Notably, this phage cocktail demonstrated low cytotoxicity in vitro to human epithelial cells, even when used alongside antibiotic treatments. These findings highlight the potential of the phage cocktail as a tool to increase antibiotic treatment success in prosthetic joint infections.
    Keywords:  Staphylococcus; antibiotic resistance; bacteriophages; biofilms; cytotoxicity; phage therapy; prosthetic joint infection; sequencing
    DOI:  https://doi.org/10.1093/sumbio/qvae028
  6. Microbiol Spectr. 2026 Aug 12. e0182026
    Dental wastewater reveals a hidden reservoir of oral bacteriophage diversity.
    Carli Roush, Marvin Whiteley.
      Bacteriophages (phages) are being explored as alternatives or complements to antibiotics because of their ability to selectively kill bacterial pathogens. However, phages that infect many oral bacteria remain undiscovered. Here, we discovered that dental wastewater harbors previously underexplored phage diversity. Viral particles concentrated from dental wastewater displayed diverse morphologies, including abundant filamentous phage-like particles. Deep long-read metagenomic sequencing of concentrated viral particles generated 7.4 billion bases of sequence data and yielded 255 medium- to high-quality viral operational taxonomic units (vOTUs), including 46 predicted complete genomes. Comparison with large phage databases revealed that 63 of these 255 vOTUs had no detectable match, indicating that extensive sequencing of dental wastewater substantially expands the number of potential bacteriophages associated with the human oral microbiome. Host prediction linked many vOTUs to oral-associated bacterial taxa, including species with few or no previously reported phages, such as Porphyromonas gingivalis, Tannerella forsythia, and Candidatus Saccharibacteria. Functional annotation identified diverse genes associated with antiphage defense systems within a subset of vOTUs, suggesting that oral phages may contribute to the movement of genes encoding bacterial immune functions within the oral microbiome. Together, these findings expand the known oral phageome and show that dental wastewater contains a largely untapped diversity of phages.IMPORTANCEThe human oral cavity contains a diverse microbial community, but the bacteriophages (phages) that infect many oral bacteria remain poorly characterized. This gap limits our understanding of how phages shape oral microbial communities. Here, we show that dental wastewater is an underexplored source of oral phage diversity. Deep long-read metagenomic sequencing revealed 255 medium- to high-quality phage operational taxonomic units, many of which are not present in existing oral phage databases. These genomes include predicted phages of periodontal disease-associated bacteria and other oral taxa with few or no known phages. Dental wastewater therefore expands the known human oral phageome and reveals candidate phages linked to bacteria associated with oral health and disease.
    Keywords:  bacteriophage; dental wastewater; oral microbiome; periodontal disease; phageome; viral metagenomics
    DOI:  https://doi.org/10.1128/spectrum.01820-26
  7. Microb Drug Resist. 2026 Aug 14. 10766294261478183
    Letter: Beyond the Petri Dish: Why Phage Therapy Has yet to Reach Routine Clinical Practice.
    Abed Zahedi Bialvaei.
      
    DOI:  https://doi.org/10.1177/10766294261478183
  8. BMC Microbiol. 2026 Aug 12. pii: 732. [Epub ahead of print]26(1):
    Evaluation of a phage-inclusive multimodal strategy for recurrent urinary tract infections.
    Simone C Lieberknecht-Jouy, Thomas Fließwasser, Dajana Pavlovic, Lucas J Fein, Verena Wiemann, Trang Do, Denia Frank, Tobias Weirauch, Annika Y Classen, Silvia Würstle, Thomas A Wichelhaus, Maria J G T Vehreschild.
      Urinary tract infections (UTIs) are among the most common bacterial infections worldwide and are associated with high recurrence rates and substantial morbidity. New therapeutic approaches are urgently needed, especially for recurrent UTIs (rUTIs), among which phage therapy represents a promising option. Here, we systematically evaluated the performance of six E. coli phages under urinary tract-relevant conditions and established a quantitative area-under-the-curve (AUC)-based framework for the rational selection of therapeutic phages. Phage lysis behavior was tested under oxic and anoxic conditions, revealing modulation by oxygen availability. Phages were also screened for biofilm-degrading activity, and in silico depolymerase predictions were compared with in vitro results, showing strong correlation. Phage-antibiotic interactions and refined treatment strategies were further investigated. Phages G9062, G10400, and MM02 emerged as the most promising candidates, remaining stable and active in urine under physiological pH fluctuations and exhibiting synergistic effects with gentamicin and fosfomycin, but not with the bacteriostatic nitrofurantoin. Importantly, we demonstrate that treatment sequence is a critical determinant of efficacy, with phage administration prior to antibiotic exposure consistently producing the strongest synergistic effects. These findings highlight the potential of phages as an integral component of a holistic therapeutic strategy for rUTIs.Importance Recurrent urinary tract infections (rUTIs) are a major clinical challenge characterized by repeated episodes, increasing antimicrobial resistance, and a substantial socioeconomic burden. Although bacteriophages represent a promising alternative or adjunct to antibiotics, their clinical translation has been hindered by the lack of standardized criteria for phage selection, dosing, and combination with antibiotics. This study addresses these gaps by defining key determinants of phage efficacy under conditions relevant to the urinary tract. Our findings highlight that phage performance is strongly shaped by the treatment environment and by interactions with antibiotics, and that inappropriate combinations or treatment sequences may compromise efficacy. By providing quantitative and transferable frameworks for evaluating phage effectivity, this work advances the rational development of phage-based therapies and helps bridge the gap between experimental phage research and clinically actionable treatment strategies for rUTI.
    Keywords:  Bacteriophage; Biofilm degradation; Phage activity in urine; Phage antibiotic synergy; Phage stability; Phage therapy; Urinary tract infection; rUTI
    DOI:  https://doi.org/10.1186/s12866-026-05524-4
  9. Front Cell Infect Microbiol. 2026 ;16 1880231
    Bacteriophage-mediated biofilm control: a novel targeted strategy for the management of dental caries.
    Huijie Sun, Kaiwen Zhang, Fujiang Chu, Jiajia Dong, Song Chen, Biao Ren, Qiang Guo.
      Dental caries, a globally prevalent chronic infectious disease, is driven by microbial dysbiosis of dental biofilm, involving multiple caries-associated colonizers. Conventional broad-spectrum antimicrobials and fluoride-based formulations often disrupt the commensal oral microbiota, contributing to antimicrobial resistance and imbalance of the oral ecosystem. In contrast, bacteriophage (phage) therapy has emerged as a promising precision strategy for caries control due to its high specificity, minimal off-target effects, and biofilm-disrupting capacity. Our review systematically summarizes recent advances in phage-based interventions for caries prevention and treatment. It describes the diversity and distribution of the oral phageome and its role in regulating oral microbial homeostasis. The review further details phages targeting key cariogenic bacteria, including S. mutans (e.g., φAPCM01, SMHBZ8), Actinomyces spp. (e.g., Av-1), and related phage enzymes. Core anti-bacterial and anti-biofilm mechanisms of oral phage are elucidated, such as direct bacterial lysis mediated by endolysins and holins, and inhibition and disassembly of biofilms through multiple mechanisms. Strategies for applying phages in caries management are also discussed, encompassing phage cocktails, combination therapies with conventional antimicrobials, and development of advanced delivery systems. Finally, current challenges and future directions of phage therapy are addressed. Overall, this review provides a comprehensive theoretical foundation for developing targeted, oral microbiome-friendly phage-based strategies against dental caries.
    Keywords:  Actinomyces; Streptococcus mutans; bacteriophage; biofilm; caries; oral phageome; phage therapy
    DOI:  https://doi.org/10.3389/fcimb.2026.1880231
  10. Front Cell Infect Microbiol. 2026 ;16 1865350
    Antimicrobial resistance mechanisms, treatment challenges, and emerging strategies in Stenotrophomonas maltophilia infections.
    Siyue Xu, Ziheng Wang, Beibei Li, Yingying Li, Jing Chen, Jie Li, Guangping Xu, Kun Yan, Peng Zhang.
      Stenotrophomonas maltophilia is a Gram-negative opportunistic pathogen widely distributed in natural and clinical environments, and has increasingly been recognized as a significant cause of nosocomial infections. Owing to its complex intrinsic resistance mechanisms and the continuous evolution of acquired resistance, the clinical management of S. maltophilia infections remains highly challenging. Resistance in S. maltophilia is mediated by multiple mechanisms, including chromosomally encoded L1/L2 β-lactamases, multidrug efflux pump systems, reduced outer membrane permeability, and biofilm formation, as well as the acquisition of resistance determinants via mobile genetic elements. In addition, virulence-associated traits, including quorum sensing systems, and extracellular enzyme production, contribute to host adaptation and persistent infection. Trimethoprim-sulfamethoxazole (TMP-SMX) remains the first-line therapy. However, increasing resistance has been reported in certain regions. Alternative and combination therapies, including minocycline and fluoroquinolones, are increasingly utilized. Meanwhile, emerging strategies such as efflux pump inhibitors, anti-virulence approaches, and bacteriophage therapy have attracted growing attention. This review provides a comprehensive overview of the resistance mechanisms, virulence-associated phenotypes, and current therapeutic advances of S. maltophilia, with particular emphasis on resistance evolution and novel treatment strategies. These insights may advance our understanding of host-pathogen interactions and support the development of targeted therapeutic approaches for improved clinical management.
    Keywords:  Stenotrophomonas maltophilia; antimicrobial resistance; bacteriophage therapy; biofilm formation; efflux pumps; emerging therapeutic strategies
    DOI:  https://doi.org/10.3389/fcimb.2026.1865350
  11. Sustain Microbiol. 2024 Jan;1(1): qvae030
    Exploring perceptions of bacteriophage use in the UK across the One Health spectrum: a roundtable discussion.
    Lucky Cullen, Daisy Neale, Helen Kinchin.
      In 2022, the UK Government launched the My Science Inquiry, an open call for potential topics of inquiry within science and technology. Applied Microbiology International (AMI) recommended bacteriophage as an alternative to antimicrobials, due to the increasingly serious threat of antimicrobial resistance. This resulted in an inquiry and report by the House of Commons Science, Innovation & Technology Committee, for which the government published a response in March 2024. In July 2024, AMI held a closed roundtable discussion, inviting bacteriophage experts across the One Health spectrum and all stages of the phage development pipeline to discuss some of the major barriers to phage therapy implementation within the UK. Overall, the lack of investment, national infrastructure and public awareness regarding phage therapy, its development and its potential, were agreed upon as the key barriers that need to be overcome to more widely implement phage therapy across the UK. Continuation of the Phage Innovation Network was repeatedly recognized as an essential requisite for overcoming these barriers and for ensuring the progress of phage innovation. The aim of this paper is to provide a progressive step for phage therapy, continuing momentum to facilitate their widespread implementation nationally.
    DOI:  https://doi.org/10.1093/sumbio/qvae030
  12. Phage (New Rochelle). 2026 Jun;7(2): 147-155
    Characterization of Enterococcus faecium-Targeting Minhovirus Bacteriophages.
    Eric Evans, Shinjiro Ojima, Wakana Yamashita, Kotaro Kiga, Daria Van Tyne.
       Background: Enterococcus faecium are gram-positive, multidrug-resistant bacteria that are endemic in healthcare settings. Bacteriophage therapy could be an adjunctive treatment for E. faecium infections.
    Materials and Methods: We isolated four new Minhovirus phages using E. faecium strain ATCC 19434 as a host.
    Results: Phage genomes were each ~19 kb in length, and were highly related to each other and to other previously isolated Minhovirus phages. Host range testing suggested a narrow spectrum of activity. In vitro-evolved phage-resistant mutants acquired mutations in the enterococcal polysaccharide antigen (epa) and capsular polysaccharide (cps) loci. Additional testing found that some phages were able to infect E. faecium clinical isolates with similar epa loci, further implicating epa as a putative receptor for Minhovirus phage infection.
    Conclusions: Overall, this study increases our understanding of phages that target E. faecium and increases the number of characterized phages that are active against this important pathogen.
    Keywords:  Enterococcus faecium; Minhovirus; enterococcal polysaccharide antigen
    DOI:  https://doi.org/10.1177/26416549251413133
  13. Int J Womens Health. 2026 ;18 603563
    Vaginal Microbiota Dysbiosis and Infections: A Comprehensive Review of Microbial and Therapeutic Perspectives.
    Samaneh Mazinani, Mohammad Aghazadeh, Vahid Arefi, Sepehr Taghizadeh, Bahareh Mehramuz, Hossein Samadi Kafil.
      The maintenance of vaginal microbial homeostasis is essential for women's reproductive health, serving as a primary defense against genital tract infections. Disruption of this ecosystem (dysbiosis) is associated with chronic inflammation, recurrent infections, adverse pregnancy outcomes, and increased susceptibility to sexually transmitted infections. This comprehensive review examines the consequences of this disruption, addressing all categories of vaginal infections, including bacterial, viral, parasitic, and fungal. A specific focus is placed on Bacterial Vaginosis (BV), Vulvovaginal Candidiasis (VVC), and Trichomoniasis, which collectively account for approximately 70% of vaginitis cases. The article provides an integrated analysis structured across three critical dimensions: Microbial Pathogenesis, detailing the mechanisms of virulence, polymicrobial biofilm formation (eg, Gardnerella vaginalis), and the development of antimicrobial resistance (AMR); Host-Microbe-Immune Interface, which explores the chronic inflammatory state and the heightened susceptibility to ascending infections (PID) and viral coinfections (HPV, HIV); and Therapeutic Innovation. Concluding with a forward-looking perspective, we discuss emerging microbiota-targeted therapeutic approaches and the potential transition toward precision medicine, including CRISPR-based genomic editing, phage therapy, and nanomedicine, which represent promising avenues for future research and clinical translation. Overall, this review integrates current evidence on vaginal dysbiosis and microbiota-targeted therapies, providing a comprehensive perspective that may support future research and precision-based clinical management.
    Keywords:  bacterial vaginosis; dysbiosis; sexually transmitted infections; vaginal microbiota; vulvovaginal candidiasis
    DOI:  https://doi.org/10.2147/IJWH.S603563
  14. Georgian Med News. 2026 May; 6-17
    EARLY HUMORAL IMMUNE RESPONSES TO BACTERIOPHAGES AND SHORT-COURSE PHAGE THERAPY OUTCOMES IN PATIENTS WITH URINARY TRACT INFECTIONS.
    E Didebulidze, L Nadareishvili, S Sturua, G Berishvili, S Tsertsvadze, N Janelidze, N Geliashvili, M Kutateladze, P Lydyard, M Tediashvili.
      Urinary tract infections (UTIs) cause significant morbidity in the adult population. Increased drug resistance and biofilm formation by uropathogenic bacteria make their eradication difficult. Phage therapy (PT), especially using custom-made preparations, is regarded as a valuable alternative treatment with promising results. The PT outcome is highly dependent on the appropriate selection of candidate phages for therapeutic mixtures and the effective routes and duration of administration. However, activation of the body's immune mechanisms through phage administration could play a negative role. A number of studies have shown the presence of antiphage antibodies (APA) in the sera of phage-treated patients, but their presence in other biological fluids still remain unclear. We studied the early antibody responses in 11 patients with persistent UTIs treated at the Eliava Phage Therapy Center (EPTC) with custom or commercial phage preparations administered orally, rectally, vaginally, intravesically, or in combined modes. PT efficacy was monitored clinically and bacteriologically. APAs in serum, urine, and saliva were measured by neutralization assay and ELISA before therapy, on day 7, and day 14. Natural APA levels were measured in 6 healthy volunteers as well. Low baseline APA levels were detected in both patients and healthy subjects. During PT, in most patients increasing APA responses were detected in serum, and to a lesser extent in urine and saliva. No significant influence of APA levels on PT outcome during short-term treatment was found.
  15. Res Vet Sci. 2026 Aug 03. pii: S0034-5288(26)00309-7. [Epub ahead of print]210 106355
    Nonliving biotherapeutics for veterinary enteric disease: Postbiotics, bacteriophage, and antivirulence strategies to reduce antibiotic dependence.
    Sajid Ali, Atif Ali Khan Khalil.
      Enteric diseases in poultry and neonatal calves remain major drivers of productivity loss and therapeutic antimicrobial use, thereby contributing to antimicrobial resistance. Necrotic enteritis in poultry is estimated to cost the global industry US $5-6 billion annually, while neonatal calf diarrhea is reported as a leading cause of morbidity (∼20-40%) and mortality (up to 8%). Nonliving biotherapeutics have attracted increasing attention because they can reduce antibiotic dependence without requiring live microbial engraftment and can be formulated for stability and consistent delivery. This review synthesizes evidence for three nonliving biotherapeutic classes: postbiotics, bacteriophages, and antivirulence strategies. Postbiotics, preparations comprising inanimate microorganisms and/or their components, can strengthen epithelial barrier integrity, modulate mucosal immunity, suppress pathogen growth, and improve redox balance, though consistent efficacy depends on delivery kinetics (e.g., protected butyrate). Phage therapy enables pathogen-specific reduction with minimal nontarget effects; controlled and commercial-scale poultry studies report reductions that can reach multi-log levels in favorable deployments, but outcomes remain sensitive to host range, formulation, and resistance management. Antivirulence approaches (quorum sensing interference, toxin neutralization, and adhesion and biofilm disruption) aim to reduce disease severity by suppressing pathogenic behaviors, potentially lowering selection pressure compared with broad bactericidal exposure. However, these interventions are not intrinsically free of antibacterial selection or implementation risks. Bacteriocins and other microbial antimicrobial peptides exert direct antibacterial activity, whereas successful phage therapy requires timely identification of the causal bacterium, confirmation of phage-host compatibility, reliable delivery, and surveillance for resistance. Product heterogeneity, variable field exposure, incomplete standardization, and regulatory and diagnostic constraints continue to limit routine adoption. We propose a syndrome-specific, stage-based selection framework for poultry necrotic enteritis and dysbiosis-associated diarrhea and calf diarrhea complex and highlight minimum characterization and trial endpoint standards required for field translation.
    Keywords:  Antivirulence therapy; Bacteriophages; Calf Diarrhea; Enteric diseases; Postbiotics; Poultry
    DOI:  https://doi.org/10.1016/j.rvsc.2026.106355
  16. Curr Res Microb Sci. 2026 ;11 100652
    Isolation, characterization, and alginate hydrogel delivery of a Klebsiella aerogenes bacteriophage and its impact on biofilm degradation.
    Istiaque Zaeem, Shakhinur Islam Mondal, Raphael Kabir Niloy, Nurnabi Azad Jewel, Mohiminur Rahman Mahin, Rita Bhatta, Daniyal Karim, Mohimenul Haque Rolin, Mohsina Khatoon, Arzuba Akter.
      Multidrug-resistant Klebsiella aerogenes poses a significant clinical challenge due to its antimicrobial resistance and biofilm-forming capacity in chronic wounds and device-associated infections. Bacteriophage therapy offers a promising alternative to conventional antibiotics, though effective delivery systems remain critical for clinical translation. This study reports the isolation, genomic characterization, and alginate hydrogel-based formulation of a lytic bacteriophage, KA_SGEB_01, targeting multidrug-resistant K. aerogenes. The phage was isolated from hospital sewage using multidrug-resistant K. aerogenes as a host. Comprehensive characterizations included plaque morphology and host range determination, multiplicity of infection (MOI) optimization, one-step growth kinetics, antibiofilm activity assays, and environmental stability testing. Complete genome sequencing and annotation were performed. Phage-loaded alginate hydrogels were developed and evaluated for release kinetics, long-term viability, and antibiofilm efficacy. KA_SGEB_01 produced clear plaques (1 ± 0.1 mm) with halos indicative of depolymerase activity and exhibited strict host specificity. The optimal MOI was 0.01 with a 15-minute latent period and the phage remained stable between -20 °C and 50 °C; and across a pH range 6-9. Biofilm assays demonstrated around 60% Crystal-Violet-stained biomass reduction as well as significant biofilm disruption visualized by Scanning Electron Microscopy. Whole-genome sequencing revealed a 175,095 bp double-stranded DNA genome encoding 289 predicted coding sequences, classified within the family Straboviridae, genus Slopekvirus, and lacking any virulence or AMR genes. Encapsulation in alginate hydrogels preserved viability (>10⁹ PFU/mL) for 14 days and enabled sustained release (∼ 67% at 72 h), resulting in significant biofilm biomass inhibition. Collectively, KA_SGEB_01-loaded alginate hydrogels represent a promising platform for treating multidrug-resistant K. aerogenes in wound and device-associated infections caused by the bacterium.
    Keywords:  Antimicrobial resistance; Bacteriophage; Hydrogel; K. aerogenes; Phage delivery; Phage therapy
    DOI:  https://doi.org/10.1016/j.crmicr.2026.100652
  17. Mol Biol Rep. 2026 Aug 14. pii: 1406. [Epub ahead of print]53(1):
    Non-Drug therapeutic strategies to combat antimicrobial resistance in livestock: a review.
    Dejen Asaye Mengistu, Yesuneh Tefera Mekasha, Fentahun Wondmnew Molla.
       BACKGROUND: Antimicrobial resistance (AMR) represents an escalating global public health crisis, projected to cause 10 million deaths annually by 2050. Pathogens such as bacteria, viruses, fungi, and parasites evade treatments in animals and humans due to overuse and misuse of antimicrobials, particularly antibiotics, in medical and veterinary practices. This drives a worldwide surge in resistant infections, disproportionately burdening livestock health and productivity.
    OBJECTIVES: This review examines the global rise of AMR and its impacts on livestock and public health, underscoring the need for non-drug therapeutic alternatives.
    CONCLUSION: Promising alternatives include genetic engineering and CRISPR-Cas systems, phage therapy, probiotics, antimicrobial peptides, fecal microbiota transplantation, phytotherapy and essential oils, immunomodulators, nanotechnology, biofilm disruptors, acidifiers, vaccination strategies, and precision livestock farming. These approaches target resistance mechanisms without relying on conventional drugs. Despite challenges like knowledge gaps, regulatory barriers, financial limitations, and policy gaps, stakeholders must prioritize accelerated research, regulatory reforms, investments, and international collaboration. Rapid integration of these technologies into human and veterinary medicine is vital to mitigate AMR's health, economic, and social impacts.
    Keywords:  Alternative therapeutic technologies; Antimicrobial resistance; CRISPR/Cas9; Livestock; Nanotechnology; Phage therapy; Probiotics
    DOI:  https://doi.org/10.1007/s11033-026-12567-3
  18. Int J Mol Sci. 2026 Jul 24. pii: 6584. [Epub ahead of print]27(15):
    Effects of Non-Surgical Periodontal Therapy on Dental Plaque Microbiome.
    Qingguo Wang, Bing-Yan Wang, Derek Wilus, Hua Xie.
      Periodontitis, a chronic inflammatory disease affecting approximately 40% of U.S. adults aged 30 years and older, is characterized by dysbiosis of the dental plaque microbiome. However, although scaling and root planing (SRP) is the cornerstone of periodontal treatment, its effects on the taxonomic composition and functional potential of the dental plaque microbiome remain incompletely understood. In this study, we used whole-metagenome shotgun sequencing to characterize taxonomic composition and functional potential in dental plaque microbiomes collected from 39 patients with Stage II or III generalized periodontitis before and 3-4 months after SRP. Consistent with clinical improvement, periodontal therapy significantly reduced probing depth, clinical attachment level, bleeding on probing, and plaque index. Whole-metagenome shotgun sequencing identified 3.18 million non-redundant genes and 12,353 microbial species across 78 samples, revealing increased gene and species richness after treatment, along with a significant restructuring of the microbial community. Established periodontal pathogens, including Porphyromonas gingivalis, as well as the emerging pathogens Escherichia coli and Burkholderia multivorans, decreased following treatment. Tannerella forsythia also showed a marked reduction after treatment, although this decrease was not significant after false discovery rate (FDR) correction. In contrast, health-associated early colonizers, including multiple Actinomyces species and Streptococcus cristatus, increased. Functional annotation using the Carbohydrate-Active Enzymes (CAZy) database identified significant treatment-associated differences in carbohydrate-active enzymes, including multiple glycosyltransferases, indicating remodeling of the predicted functional potential of the dental plaque microbiome. These findings demonstrate that successful SRP promotes coordinated taxonomic and predicted functional remodeling of the dental plaque microbiome and highlight the value of shotgun metagenomic sequencing for characterizing both taxonomic and functional recovery following periodontal therapy.
    Keywords:  dental plaque microbiome; functional profiling; periodontitis; scaling and root planing; shotgun metagenomics sequencing
    DOI:  https://doi.org/10.3390/ijms27156584
  19. Clin Infect Dis. 2026 Aug 11. pii: ciag446. [Epub ahead of print]
    First-in-Human Adjunctive Bacteriophage Therapy for Malakoplakia.
    Saima Aslam, Aleah Brubaker, Mita Shah, Thomas C S Martin, Tyler Mandt, Austin-Marley Windham-Herman, Haiyan Zhang, Tina Bryde, Yilmaz Emre Gençay, Aurelie Gram, Christian Grøndahl, Jakob Krause Haaber, Björn Hallström, Eric van der Helm, Jonas Hink, Lorrie Maccario, Anders Østergaard, Alice Troy, Niloofar Yavari, Robert T Schooley, Sanjay Mehta.
      We report the first use of adjunctive bacteriophage therapy for Escherichia coli related malakoplakia in a kidney transplant recipient with progressive disease. Adjunctive CRISPR-enhanced phage cocktail SNIPR001 combined with prolonged antibiotics, ascorbic acid, and bethanechol was associated with cutaneous lesion resolution and sustained radiographic regression without phage-related adverse events.
    Keywords:  kidney transplant; malakoplakia; phage therapy
    DOI:  https://doi.org/10.1093/cid/ciag446
  20. J Clin Periodontol. 2026 Aug 09.
    Shotgun Metagenomic Analysis Reveals Taxonomic and Functional Transitions in the Salivary Microbiome During Periodontal Disease Progression.
    Muhammed Manzoor, Jaakko Leskelä, Eija Könönen, Leo Lahti, Jukka Putaala, Pirkko J Pussinen, Susanna Paju.
       AIM: To characterise multi-kingdom salivary microbiome profiles across clinically defined periodontal states and identify stage-specific taxonomic and functional alterations using shotgun metagenomic sequencing.
    MATERIALS AND METHODS: In this cross-sectional study, 204 adults (mean age 40.3 ± 7.6 years) from the SECRETO study (NCT01934725) underwent clinical and radiographic oral examinations and were classified into six periodontal groups: periodontal health, localised gingivitis, generalised gingivitis, gingivitis with pockets, mild periodontitis (Stages I-II) and severe periodontitis (Stages III-IV). Saliva samples were analysed using shotgun metagenomic sequencing to evaluate microbial diversity, taxonomic composition and functional pathways.
    RESULTS: Beta diversity differed between periodontal health and the different disease states (Bray-Curtis: p = 0.049; Jaccard: p = 0.043). Gingivitis with pockets and severe periodontitis showed a significant enrichment of disease-associated species Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Porphyromonas endodontalis, Fusobacterium nucleatum and Parvimonas micra. Among non-bacterial taxa, Candida, Moineauvirus, Pyricularia and Roseolovirus were the predominant genera. A composite metagenomic classifier showed high discriminative performance for gingivitis with pockets (AUC = 0.90; 95% CI: 0.770-1.000) and severe periodontitis (AUC = 0.865; 95% CI: 0.762-0.968).
    CONCLUSION: Salivary multi-kingdom microbiome transitions closely reflect the progression of periodontal disease and provide promising biomarkers for identifying at-risk individuals.
    Keywords:  gingivitis; microbial dysbiosis; multi‐kingdom interactions; oral biomarkers; oral microbiome; periodontitis; saliva metagenomics
    DOI:  https://doi.org/10.1111/jcpe.70184
  21. J Infect Dis. 2026 Aug 11. pii: jiag407. [Epub ahead of print]
    Unraveling Resistance and Thresholds in Phage Therapy Using In Vitro Staphylococcus aureus experiments and Pharmacokinetic/Pharmacodynamic Models.
    Kévin Royet, Leslie Blazere, Emilie Helluin, Ludivine Coignet, Lucile Plumet, Mélanie Bonhomme, Camille Kolenda, Romain Garreau, Florent Valour, Mathieu Medina, Frédéric Laurent, Sylvain Goutelle.
       BACKGROUND: Phage therapy is a promising approach for infections caused by multidrug-resistant Staphylococcus aureus, but its clinical development is limited by knowledge gaps in pharmacokinetic/pharmacodynamic (PK/PD) and potential emergence of resistance.
    METHODS: We performed in vitro time-kill assays to study the effect of three anti-staphylococcal phages (V1SA019, V1SA020, V1SA022) against two S. aureus strains (SH1000 and USA300). Resistance emergence was monitored through phenotyping and whole-genome sequencing of resistant clones.Bacteria and phage counts were analyzed by pharmacokinetic/pharmacodynamic (PK/PD) modeling with a non-linear mixed effects approach to quantify parameter variability.
    RESULTS: Phage-bacteria interactions followed a predator-prey pattern resulting in fast bacterial collapse. However, bacterial regrowth attributed to resistance was observed in some experiments and was associated with initial multiplicity of infection (MOI). All resistant clones harbored mutations in genes involved in teichoic acid biosynthesis, with associated growth defects. The PK/PD models adequately described bacterial and phage dynamics. Phage binding rate of resistant bacteria was 35 to 250-fold lower than that for susceptible bacteria, resulting in higher proliferation (45 to 310-fold) and higher inundation thresholds (34 to 190-fold). Parameters also varied between the two bacteria strains. Model-based simulations suggested that suppression of resistance require an initial phage dose exceeding the inundation threshold of both susceptible and resistant bacteria subpopulations.
    CONCLUSIONS: This study provides a quantitative in vitro framework for understanding the S. aureus and phage co-dynamics and resistance emergence. The identified threshold phenomena offer insights into the experimental dose-response relationship and may guide future investigations.
    Keywords:   Staphylococcus aureus ; Phage therapy; antimicrobial resistance; pharmacodynamics; pharmacokinetics
    DOI:  https://doi.org/10.1093/infdis/jiag407
  22. Front Cell Infect Microbiol. 2026 ;16 1859519
    The impact of organ transplantation on changes in the oral microbiome, particularly on bacteria causing periodontal inflammation - narrative review.
    Iwona Ordyniec-Kwaśnica, Damian Muszyński, Bartosz Słomiński, Mateusz Lampkowski, Anna Kudra.
      With the development of technology and medicine, more and more diseases in today's world are becoming curable. Ultimately, when there is no improvement in health and a deterioration in the efficiency or functionality of a given organ, organ transplantation becomes the only option. In 2024 alone, data from the Global Observatory on Donation and Transplantation indicate that over 173, 000 organ transplants were performed worldwide, reflecting a consistent upward trend in recent years The introduction of a "foreign" organ into the body is not without consequences. Clinical manifestations may vary, including, among others, transplant rejection. These alterations may also extend to highly sensitive biological environments such as the oral microbiome, particularly affecting bacterial populations implicated in gum/gingival inflammation. This publication shows what microbiological changes can be caused by the transplantation of certain organs and whether, in general, every transplant means the same change in the oral microbiota.
    Keywords:  dysbiosis; oral health; oral microbiome; periodontal inflammation; transplantation
    DOI:  https://doi.org/10.3389/fcimb.2026.1859519
  23. J Oral Maxillofac Pathol. 2026 Apr-Jun;30(2):30(2): 217-223
    Crosstalk between salivary citrullinated proteins and oral health status in patients with rheumatoid arthritis: A cross-sectional study.
    Nandita Kulkarni, Varsha Vimal Kumar, S Chandrashekara, Suraj Sathyendra, Girish Hemadala Channabasavaiah, Mayukh Dey.
       Context: Rheumatoid arthritis (RA) is often associated with reduced salivary flow, increasing susceptibility to opportunistic oral infections. Evidence suggests shared pathogenic mechanisms between RA and periodontitis. As a non-invasive medium, saliva offers potential for evaluating associations between anti-citrullinated protein antibody, Porphyromonas gingivalis, and RA.
    Aims: To measure salivary citrullinated proteins in RA patients, detect P. gingivalis and Candida species, and assess associated oral changes.
    Settings and Design: Cross-sectional study including 21 RA patients and 21 age- and gender-matched healthy controls.
    Materials and Methods: Unstimulated saliva was collected for citrullinated protein estimation using enzyme-linked immunosorbent assay and cultured on Sabouraud dextrose agar for Candida quantification. Subgingival plaque samples were analysed for P. gingivalis. Oral status was assessed using the Community Periodontal Index (CPI) and decayed, missing, and filled teeth (DMFT) index.
    Statistical Analysis Used: Mann-Whitney test, Chi-square, the Independent Student t-test, and one-way ANOVA test were used.
    Results: Salivary citrullinated proteins showed significant positive correlation with Candida (P = 0.003), P. gingivalis (P < 0.001), and DMFT scores (P = 0.001). RA patients demonstrated significantly higher colony-forming units of Candida (5.11 ± 0.50 vs. 2.13 ± 0.16 log10; P < 0.001) and P. gingivalis (5.20 ± 0.08 vs. 2.12 ± 0.29 log10; P < 0.001). CPI scores correlated with microbial load (Candida, P = 0.04; P. gingivalis, P = 0.009).
    Conclusions: Although not a standalone diagnostic marker, salivary citrullinated proteins correlate with microbial load and caries, supporting saliva-based biomarkers for RA monitoring.
    Keywords:  Anti-citrullinated protein antibody; Candida albicans; Porphyromonas gingivalis; rheumatoid arthritis
    DOI:  https://doi.org/10.4103/jomfp.jomfp_341_25
  24. J Indian Soc Periodontol. 2026 Apr-Jun;30(2):30(2): 302-308
    Rubia cordifolia as an antimicrobial agent against periodontal pathogens - An in vitro microbiological study.
    Swapna Shivasharan Gore, Pranjali Girish Mandurkar.
       Background: Extensive research on the antimicrobial activity of medicinal plants for periodontal therapy has been conducted over the past decades. The gradual increase in antibiotic resistance necessitates research for new antimicrobial compounds. Rubia cordifolia has exhibited reassuring antimicrobial potential against Gram-positive and Gram-negative bacteria. However, no study has yet evaluated its therapeutic potential in periodontal diseases. Therefore, we aimed to design, formulate, and evaluate the antimicrobial activity of R. cordifolia root extract against periodontal pathogens.
    Materials and Methods: Extract of the roots of R. cordifolia was prepared using cold maceration and methanol extraction. The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and time-kill curve (TKC) analysis of R. cordifolia extract were assessed against Porphyromonas gingivalis (Pg), Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum (Fn), and Prevotella intermedia, where chlorhexidine was utilized as a control drug.
    Results: The MIC value for Fn was 0.8 μg/mL, representing the lowest value observed, whereas Pg exhibited the highest MIC value at 6.25 μg/mL. The MBC values ranged from 6.25 μg/mL to 12.5 μg/mL. The TKC revealed a kill time of 2 h for all tested organisms except Pg.
    Conclusion: The methanolic extract derived from the roots of R. cordifolia demonstrated bactericidal effects against keystone pathogens associated with periodontitis. Consequently, there is a critical requirement of additional clinical studies to assess its potential therapeutic application in the treatment of periodontal disease.
    Keywords:  Biofilm; Porphyromonas gingivalis; Rubia cordifolia; in vitro; methanolic extract; periodontitis
    DOI:  https://doi.org/10.4103/jisp.jisp_164_24
  25. Am J Perinatol. 2026 Aug 14.
    Late-Onset Neonatal Sepsis: Contemporary Epidemiology, Diagnosis, Prevention, and Precision Therapeutics.
    Shweta Dixit, Shilpa Dixit, Yashwant Kumar Rao, Anirudha Das.
       OBJECTIVES: Late-onset neonatal sepsis (LOS) remains a major challenge in modern neonatal intensive care units (NICUs), disproportionately affecting very low birth weight (VLBW) and extremely preterm infants. Despite advances in perinatal care, LOS continues to contribute to high mortality, prolonged hospitalization, and long-term neurodevelopmental impairment. Emerging trends-including evolving pathogen profiles, increased antimicrobial resistance (AMR), and widespread microbiome disruption-highlight persistent clinical and public health concerns. This review synthesizes current evidence on the epidemiology, pathophysiology, diagnosis, and management of LOS, with emphasis on evolving diagnostics, antimicrobial stewardship, prevention strategies, and emerging precision approaches. Key gaps and research priorities are highlighted to inform future clinical practice and neonatal health policy.
    STUDY DESIGN: This narrative review synthesizes contemporary literature, including multicenter cohort studies, national registries, and emerging diagnostic and predictive technologies.
    RESULTS: LOS arises from the complex interplay between neonatal immune immaturity, invasive NICU interventions, and microbial exposure. Gram-positive organisms predominate in high-income settings, while multidrug-resistant Gram-negative pathogens are increasingly reported in low- and middle-income countries, contributing to higher morbidity and mortality. Early-life antibiotic exposure and dysbiosis compromise the gut microbiome, further increasing susceptibility. Clinical recognition remains challenging due to nonspecific signs, often leading to delayed or excessive empiric antibiotic therapy. Rapid molecular diagnostics, emerging predictive tools, including early-warning models, and serial biomarker monitoring offer opportunities for pathogen-directed therapy, individualized pharmacokinetic optimization, and safe antimicrobial stewardship. Prevention through central-line bundles, human milk feeding, probiotics, strict hand hygiene, and context-specific infection-control strategies remains central to reducing LOS incidence.
    CONCLUSIONS: LOS represents a multifactorial syndrome with profound implications for survival and neurodevelopment in preterm and VLBW infants. Effective management requires integration of precision diagnostics, individualized therapy, microbiome-preserving strategies, neuroprotective interventions, and equitable implementation of prevention and stewardship programs. Bridging mechanistic understanding with scalable, context-sensitive approaches is critical to improving survival, reducing morbidity, and optimizing long-term outcomes.
    DOI:  https://doi.org/10.1055/a-2938-3600
  26. Immunobiology. 2026 Aug 08. pii: S0171-2985(26)00074-4. [Epub ahead of print]231(5): 153228
    Exploring the mechanism underlying negative pressure wound therapy in promoting the healing of diabetic foot ulcers via integrated multi-omics and bioinformatics approaches.
    Sisi Wang, Haidong Zhou, Zihao Zhang, Yancang Li, Liying Wang, Jinyou Nie, Zeyu Hou, Jihua Wei, Haiping Di, Xiaoliang Li.
       BACKGROUND: Diabetic foot ulcers (DFU) are one of the most serious complications of diabetes, closely associated with high amputation rates, mortality, and healthcare burdens, and the clinical treatment research is still limited. Negative Pressure Wound Therapy (NPWT) is a treatment modality for DFU, but its specific mechanisms promoting wound healing remain largely unknown.
    METHODS: The bulk RNA-seq and scRNA-seq data for DFU used in this study were obtained from the GEO database. First, this study used differential analysis and multiple machine learning algorithms to identify key genes activated by NPWT. Subsequently, this study used GSVA and AddModuleScore analysis to evaluate the mesenchymal-epithelial transition (MET) capability of keratinocytes (KCs), and used CytoTRACE and pseudotime trajectory analysis to construct MET differentiation trajectories. Finally, immunofluorescence (IF) was used to validate the expression of GRHL2 in DFU clinical samples.
    RESULTS: Differential expression analysis identified 975 dysregulated genes in DFU (530 upregulated, 445 downregulated). Through four machine learning algorithms, GRHL2 was consistently selected. GRHL2 was primarily expressed in skin at both RNA and protein levels. Single-cell analysis of 13 DFU samples confirmed GRHL2 is predominantly expressed in KCs. Specifically, NPWT activates GRHL2, thereby driving mesenchymal fibroblasts (MFs) into supraspinous_KCs. Additionally, molecular docking suggests that Parthenolide, MG-132, Mitoxantrone, and Irinotecan may have potential efficacy in treating DFU. Finally, IF results show that GRHL2 expression is consistent with transcriptomic analysis results.
    CONCLUSION: Overall, this study established a MET model of "MFs - supraspinous_KCs" in DFU repair. Additionally, the "NPWT - GRHL2 - MET - cell conversion" signaling axis proposed in this study supplements the molecular mechanism by which NPWT promotes wound healing through the regulation of cell fate determination, deepening the biological effects of physical stimulation from the macroscopic tissue repair phenotype to the microscopic cell conversion level, and further enriching the mechanism by which NPWT promotes wound healing.
    Keywords:  Bioinformatics; Diabetic foot ulcers; Machine learning; Negative pressure wound therapy; scRNA-seq
    DOI:  https://doi.org/10.1016/j.imbio.2026.153228
  27. BMC Vet Res. 2026 Aug 11. pii: 466. [Epub ahead of print]22(1):
    Actinobacillus pleuropneumoniae - today's perspective on advances and challenges (2017- 2026).
    Isabel Hennig-Pauka, Katrin Strutzberg-Minder, Paul R Langford.
      Actinobacillus pleuropneumoniae (APP) remains one of the most significant bacterial respiratory pathogens in swine production worldwide, causing porcine pleuropneumonia with substantial economic impact. Although recent reviews have summarized aspects of APP epidemiology, serotyping, surface-associated virulence determinants, and vaccine development strategies, several complementary research areas have advanced rapidly since the last DISease CONtrol TOOLS (DISCONTOOLS) 2017 report on this bacterium. These include antimicrobial resistance surveillance, chronic persistence mechanisms such as biofilm formation, refined experimental infection models, intracellular survival within host immune cells, and the immunopathological processes driving lung injury. This review focuses on these practical and mechanistic dimensions, emphasizing their relevance for herd-level control, outbreak management, and future therapeutic approaches. Recent genomic studies of multidrug-resistant strains, as well as the development of improved molecular diagnostic tools, are also discussed. Collectively, emerging evidence suggests that APP should not be viewed solely as an extracellular pathogen causing acute disease outbreaks, but rather as an adaptable organism capable of persistence, immune modulation, and endemic circulation in modern pig populations. Addressing these challenges will require integrated strategies that combine antimicrobial stewardship, improved surveillance, and a deeper understanding of host-pathogen interactions.
    Keywords:  Antimicrobial resistance; Biofilm; Diagnostics; Immunopathology; Infection models; Prevention; Swine; Treatment; Virulence
    DOI:  https://doi.org/10.1186/s12917-026-05791-3
  28. Infect Dis Health. 2026 Aug 12. pii: S2468-0451(26)00047-7. [Epub ahead of print]31(4): 100453
    In vitro bactericidal activity of retainer/denture-cleaning formulations against planktonic populations of Pseudomonas aeruginosa and other common bacterial pathogens in cystic fibrosis.
    Beverley C Millar, John E Moore.
       INTRODUCTION: Life expectancy has risen significantly in people with cystic fibrosis (PwCF) with the introduction of Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) modulators. This has resulted in new infection challenges for PwCF, including the increasing employment of dentures, which have been shown to harbour CF-related bacterial pathogens.
    HYPOTHESIS/GAP STATEMENT: To date, there is no evidence-based infection prevention and control (IPC) guidance, specific to the CF community, on how to optimally clean and disinfect dentures in PwCF, including the efficacy of denture cleaning formulations against CF pathogens.
    AIM: To examine the in vitro bactericidal activity of two leading brands of denture cleaning formulations against planktonic suspensions of CF-related bacterial pathogens.
    METHODOLOGY: CF and bronchiectasis-related bacterial pathogens were employed in this study, including Pseudomonas aeruginosa, methicillin-sensitive Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), Burkholderia multivorans, Burkholderia cenocepacia and Stenotrophomonas maltophilia. Planktonic suspensions of each organism was exposed to denture cleaning fluid for 20 min and recovery of surviving cells attempted through direct plating and enhanced enrichment methods.
    RESULTS: Pseudomonas aeruginosa was able to survive for the suggested manufacturers' exposure time (3 min). All bacteria were unable to be recovered following 20 min exposure to each of the denture cleaning formulations, as well as following enrichment in nutrient broth at both 24 h and 48 h, indicating that both formulations were completely bactericidal to all organisms tested, after exposure for 20 min.
    CONCLUSION: This study indicates that the five clinically important species of CF bacterial pathogens tested were not able to remain culturable for 20 min in planktonic form, in commonly used retainer/denture-cleaning formulations widely available on the UK High Street. Survival of Pseudomonas aeruginosa was possible if exposed for the 3 min, as indicated with the instructions of these products. Employment of successful evidence-based cleaning and disinfection regimens of retainers/dentures in people with CF will help break the chain of transmission of CF pathogens, which is especially important during eradication treatments for first isolates, thereby avoiding re-infection. Clinically, the findings of this study are important to the small number of younger individuals with CF who wear dentures, and to CF adolescents and young people with CF who wear retainers, as well as providing data for an emerging aging CF population, where dentures will become more common. Further work is however required to establish the most effective retainer/denture cleaning regimen, as well as to examine the more complex survival dynamics of these organisms on naturally derived retainer/denture biofilm, associated with dental plaque.
    Keywords:  CF; Cystic fibrosis; Dental hygiene; Dentures; Infection control; Retainers
    DOI:  https://doi.org/10.1016/j.idh.2026.100453
  29. Crit Rev Biotechnol. 2026 Aug 13. 1-39
    Enzyme-driven antimicrobial resistance and advancements in sustainable anti-infective strategies.
    Ananya Mukherjee, Damini Thakur, Maira Ahuja, Pooskuri Nayan, Lokender Kumar.
      Antibiotic resistance is an emerging global issue that has reduced the efficacy of antibiotics for treating life-threatening bacterial infections. Bacterial adaptive enzymatic defense mechanisms allow cells to activate or modify specific enzymes that inactivate antibiotics and support survival under antimicrobial stress. Antibiotics are predominantly inactivated through enzymatic degradation or chemical modification. Most of the β-lactamases, macrolide esterases, tetracycline-modifying enzymes, fosfomycin degrading enzymes, aminoglycoside-modifying enzymes, and other bacterial enzymes chemically modify or degrade the antibiotics making them inactive. This review covers classification and mechanisms of enzyme-mediated resistance and emphasizes the significant enzymes involved in inactivation of various antibiotic classes. It also summarizes recent biotechnological advances to combat antibiotic resistance, including β-lactamase inhibitors, phage therapy, antimicrobial peptides, and CRISPR-Cas9 systems, along with emerging therapeutic approaches and current trends in antibiotic research. A deeper understanding of enzyme-mediated resistance and the cellular intelligence driving bacterial adaptation is crucial for designing effective therapeutic strategies, preserving antibiotic efficacy, and reducing the global burden of resistant infections.
    Keywords:  Antibiotic resistance; aminoglycosides; enzyme-mediated antimicrobial resistance; good health and well-being; industry; innovation and infrastructure; responsible consumption and production; β-lactamase inhibitors
    DOI:  https://doi.org/10.1080/07388551.2026.2693159
  30. Front Microbiol. 2026 ;17 1880016
    Advances in antibiofilm strategies for medical implant-associated infections: emerging technologies and translational challenges.
    Aditi Sharma, Bineypreet Kaur, Aditi Goyal, Purvi, Anu Priya Minhas.
      Medical implants are instrumental for modern diagnosis, treatment, and management of disease. However, their increased usage has also raised concerns about implant associated infections. These infections are predominantly caused by microbial biofilms, conferring enhanced resistance to antimicrobial therapies, host immune responses, and environmental stresses, making infections difficult to eradicate. This review provided an updated overview of the evolving antibiofilm landscape for medical implants. It discusses major biofilm forming pathogens and mechanisms of biofilm development, followed by conventional and emerging approaches for biofilm prevention and eradication, including antifouling and antimicrobial coatings, quorum sensing inhibitors, hybrid or multifunctional or combination coatings, antimicrobial peptides, nanotechnology enabled platforms, photodynamic and photothermal therapies, immune targeting strategies, and smart coatings. The review further underscores the challenges associated with these antibiofilm strategies hindering clinical translation. Combating these challenges will play a crucial role in the future, improving antibiofilm therapies and patient outcomes in biofilm related medical implant infections.
    Keywords:  antimicrobial; biofilm; coating; implant; infection; nano
    DOI:  https://doi.org/10.3389/fmicb.2026.1880016
  31. Int J Mol Sci. 2026 Aug 01. pii: 6919. [Epub ahead of print]27(15):
    Targeted Therapy for Restoring CFTR Activity: From Experimental to Clinical Features.
    Sara Allushi, Mariarita Virgulti, Giovanna Blaconà, Giampiero Ferraguti, Adriana Eramo, Marco Lucarelli.
      Cystic fibrosis (CF) is one of the most common rare genetic diseases. It is caused by pathogenic variants of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. More than 2200 variants have been identified in the CFTR gene that need detailed knowledge and functional characterization in order to develop specific therapeutic strategies. The traditional therapy for CF relied on addressing symptoms through mucolytic and antibiotic treatments, respiratory physiotherapy and aerosol therapy. However, in the last few years, the development of small new molecules targeting and restoring the underlying CFTR channel defect marked an important step in CF treatment. In addition, the implementation of patient-specific cellular models allowed the evaluation of pharmacological responses, leading to therapeutic advances in the direction of personalized treatment. The focus of this review is to describe and discuss the strategies for restoring the CFTR functional defects depending on the specific CFTR pathogenic variants. In particular, the review highlights the possible application of experimental and clinical drugs to CF treatment, which may allow improvements in patients' quality of life and life expectancy. The in vitro testing of therapeutic drugs (theratyping) is performed nowadays through the use of several cellular models, especially those derived from patient-specific tissues. This topic is a hot point in CF research and the review also aims to provide an overview of the state of the art in theratyping. The novelty of this review is the integrated view of the most recent achievements in precision diagnostics and therapy of CF at the molecular, cellular and clinical level, which are able to change the natural history of this disease.
    Keywords:  CFTR; cystic fibrosis; epigenetics; modulators; targeted therapy
    DOI:  https://doi.org/10.3390/ijms27156919
  32. Sustain Microbiol. 2024 Jan;1(1): qvae022
    Building a future for phage-based technologies-a thought leadership approach to accelerating progress in the UK.
    Francesca E Hodges, Darren L Smith.
      Antimicrobial resistance is a global issue that threatens our ability to effectively manage and treat bacteria in the context of human health, animal health, and the environment. Bacteriophages provide a viable and necessary alternative to existing antimicrobials. Recognizing the extensive expertise and existing infrastructure that can support phage development in the UK, the Phage Innovation Network (PIN) was established with the aim of catalysing progress in this area. Through comprehensive consultation with the phage community and wider stakeholders, the PIN has carried out a variety of activities to address key issues that are considered to be preventative for the development and use of phage-based technologies in the UK. The successful outcomes of these activities demonstrate how this thought leadership approach has been effective in increasing engagement, delivering solutions, and supporting progress of the phage sector in the UK.
    Keywords:  agriculture; alternatives to antibiotics; antimicrobial resistance; bacteriophages; veterinary
    DOI:  https://doi.org/10.1093/sumbio/qvae022
  33. Evid Based Dent. 2026 Aug 13.
    Chemically modified curcumin in periodontal therapy: a scoping review.
    Vishala Bhargavi Chilukuri, Rupali Agnihotri, Deepa G Kamath.
       AIMS/OBJECTIVES: Periodontitis, a multifactorial chronic inflammatory disease that destroys the supporting structures of the teeth, is conventionally managed with treatments focusing on biofilm removal; however, these therapies do not fully address the dysregulated host response central to disease progression. To address this, chemically modified curcumin (CMC) analogues have been developed by modifying curcumin, a derivative of Curcuma longa, a host-modulating agent with potent anti-inflammatory and antioxidant properties. Recently, CMCs have been used to manage periodontitis. This scoping review systematically maps the available evidence on the therapeutic potential of CMCs and their analogues in managing periodontal disease.
    METHODS: A comprehensive literature search in online databases (PubMed, EMBASE, Scopus and Web of Science) using the keywords "chemically modified curcumin" AND "periodontitis" yielded 76 results. Among them, 15 original research studies that evaluated the effects of CMC analogues on periodontitis were reviewed according to the PRISMA-ScR guidelines.
    RESULTS: CMC2.24 was the most common analogue studied, followed by CMC 2.5, the mono-carbonyl analogue of curcumin (e.g., 1A) and iron-curcumin nanoparticles. They produced consistent anti-inflammatory and bone-protective effects across multiple in vitro, ex vivo and animal models. They suppressed the pathologically elevated MMP-9 and pro-inflammatory cytokines, including IL-1β, TNF-α and IL-6. Furthermore, they enhanced pro-resolving mediators, such as Resolvin D1. CMCs were superior to traditional curcumin, owing to their improved stability and bioavailability.
    DISCUSSION: Analysis of the extracted data from the included studies revealed that the CMC analogues effectively reduced excessive inflammation, tissue degradation and dysregulated immune response in periodontitis.
    CONCLUSION: CMC2.24 was a promising host-modulating agent in periodontal therapy. However, the results are mainly derived from preclinical studies and further human clinical trials are required to apply CMCs into everyday practice.
    DOI:  https://doi.org/10.1038/s41432-026-01237-9
  34. Front Bioeng Biotechnol. 2026 ;14 1917429
    Human relevant platforms for cutaneous wound healing research: current landscape, translational gaps, and emerging frontiers.
    Fidha Latheef, K Suthindhiran.
      Cutaneous wound healing is a dynamic, multicellular process that unfolds across four interrelated phases - haemostasis, inflammation, proliferation, and remodellingeach governed by precise intercellular signalling that remains incompletely understood in its human context. Animal models and two-dimensional cell cultures have shaped much of what we know about wound biology, yet both consistently fall short when the question moves from mechanism to translation. They fail to capture the structural organisation of human skin, the particular rhythms of human immune activation and resolution, and above all the multifactorial pathology that makes chronic wounds-diabetic foot ulcers especially, so resistant to treatment. This review traces the development of human-relevant alternative models as a coherent scientific response to those failures: from scratch assays and monocultures through to three-dimensional reconstructed equivalents, organoid platforms, ex vivo tissue preparations, and skin-on-a-chip systems capable of dynamic perfusion and real-time wound monitoring. We assess each class of model not simply on its merits but on what specific biological gap it was designed to close and what gaps remain. Emerging analytical frameworks-multi-omics integration, spatial transcriptomics, microbiome and biofilm modelling, multi-organ-on-a-chip architectures, artificial intelligence, and neuro-immune crosstalk -are examined as the next Frontier. These findings show that no single platform will resolve the translational deficit; what is required is a deliberately combinatorial paradigm in which complementary systems are deployed in tiered sequence, each contributing the biological information it is best positioned to generate.
    Keywords:  bioprinting; cutaneous wound healing; in vitro wound models; skin-on-a-chip; three-dimensional skin equivalents; translational medicine
    DOI:  https://doi.org/10.3389/fbioe.2026.1917429
  35. J Oral Biol Craniofac Res. 2026 Sep-Oct;16(5):16(5): 101497
    ESKAPE pathogens: Emerging isolates in odontogenic orofacial infections.
    P S Tripthi, Rakshita Kumar, Padmaraj Hegde.
       Introduction: Odontogenic orofacial infections involve a broad microbial spectrum, with the rise of multidrug-resistant organisms complicating management. ESKAPE pathogens, known for their ability to evade standard antimicrobial therapies, are increasingly implicated in severe infections. However, their prevalence and resistance patterns in odontogenic orofacial space infections remain insufficiently reported. This study aimed to identify the occurrence of ESKAPE pathogens in such infections and assess their antimicrobial susceptibility to guide effective treatment.
    Methodology: Between August 2019 and June 2022, 132 patients with oral and maxillofacial infections were prospectively enrolled. Pus samples collected using sterile swabs were cultured following standard protocols. Bacterial identification and susceptibility testing were performed using the VITEK 2-Compact system.
    Results: Twenty-nine samples (21.97%) yielded at least one ESKAPE pathogen, with Enterobacter species being the most common isolate (34.48%). High resistance rates were seen to amoxicillin-clavulanic acid (62.07%), cefuroxime (62.5%) and trimethoprim-sulfamethoxazole (68.42%). Linezolid, ertapenem, and clindamycin demonstrated the highest susceptibility (100%), followed by imipenem (86.96%, p ≤ 0.05). Acinetobacter baumannii demonstrated complete resistance to all tested antibiotics.
    Conclusion: ESKAPE pathogens represent a significant proportion of odontogenic orofacial infections and exhibit considerable resistance to commonly used antibiotics. These findings reinforce the necessity of culture-based therapy and highlight imipenem as a potential option for resistant cases. Strengthened antibiotic stewardship and continued surveillance are essential to manage the growing threat of multidrug-resistant organisms in maxillofacial infections.
    Keywords:  Drug resistance; ESKAPE pathogens; Oro-facial infection
    DOI:  https://doi.org/10.1016/j.jobcr.2026.101497
  36. J Wound Care. 2026 Aug 02. 35(8): 662-672
    Managing chronic wounds with TLC-NOSF dressings: evidence from a prospective real-life patient cohort.
    Philippe Léger, Julie Malloizel-Delaunay, Joséphine Moreau, Ulrique Michon-Pasturel, Benjamin Bouillet, Ariane Sultan, Sophie Schulidner, Dured Dardari, Caroline Haase-Ruby, Anne Sauvadet, Julie Doan, Agnès Hartemann, Sylvie Meaume, Hester Colboc.
       OBJECTIVE: Chronic wounds, such as venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs), remain a major healthcare challenge, particularly in France, where their management is complex and resource-intensive. Technology lipido-colloid nano-oligosaccharide factor (TLC-NOSF) dressings have demonstrated the ability to modulate the wound microenvironment, inhibit excessive matrix metalloproteinase activity and accelerate healing. Despite strong evidence and national recommendations, their use in routine practice remains limited. The STARTLIFE study aimed to generate additional real-life evidence on the effectiveness of TLC-NOSF dressings in VLUs and DFUs across diverse care settings.
    METHOD: STARTLIFE was a prospective, multicentre, non-interventional French observational study. TLC-NOSF dressings (UrgoStart Plus Border/Pad, UrgoStart Contact, Laboratoires Urgo, France) were used according to clinical practice. The primary endpoint was complete healing within 12 weeks; secondary outcomes included wound healing progression and dressing performance.
    RESULTS: From June 2022-July 2024, 229 VLUs and 138 DFUs were included at 53 French sites. Among patients with VLUs, 44.5% achieved complete healing after 72 days, with a median healing time of 60 days. In patients with DFUs, 36.8% achieved complete closure after 78 days, with a median healing time of 64 days. Earlier initiation of TLC-NOSF treatment was associated with better outcomes in both groups. Both patient and clinician satisfaction with comfort and efficacy were high.
    CONCLUSION: The findings of the STARTLIFE study provide real-life evidence demonstrating the effectiveness, safety and high acceptability of TLC-NOSF dressings in the management of VLUs and DFUs when associated with appropriate standard of care. The diverse range of TLC-NOSF dressings supports personalised wound care and reinforces its use as a first-line intervention throughout the healing process.
    Keywords:  TLC-NOSF dressings; chronic wounds; diabetic foot ulcers; observational study; venous leg ulcers; wound; wound care; wound dressing; wound healing
    DOI:  https://doi.org/10.12968/jowc.2026.0087
  37. Microb Pathog. 2026 Aug 13. pii: S0882-4010(26)00500-0. [Epub ahead of print] 108774
    Bacteriophage Cocktails for Combating Multidrug-Resistant Staphylococcus aureus Infections in Animals: A Comprehensive Review Across Pets, Livestock, and Wildlife.
    Muhammad Muneeb, Asfand Yar Khan, Aftab Shaukat, Yonggang Qu.
      Multidrug-resistant Staphylococcus aureus, including methicillin-resistant strains (MRSA) pose an increasing risk to animal health and are a known zoonotic risk in the One Health paradigm. The use of bacteriophage cocktails (combinations of two or more lytic phages) have gained interest for expanding host range, inhibiting phage-resistant mutants, and disrupting biofilms, a growing challenge in conventional antibiotic therapy. This review aims to summarise the existing literature on phage cocktails against MDR S. aureus in three different animal populations: pets, livestock and wild animals. For livestock, particularly dairy cattle, a number of cocktails have advanced from in vitro characterization and murine mastitis models to pilot field trials, with one randomized study showing an 81.3 % bacteriological cure rate for naturally occurring S. aureus mastitis. Companion animal research is in the intermediate phase, and polyvalent phages against both S. pseudintermedius and S. aureus have been shown to be effective in canine pyoderma and otitis, with a recent study of a canine fracture-related infection showing efficacy comparable to prolonged antibiotic treatment. However, there are no specific studies on wild animals and this is a gap in knowledge. Some of the ongoing problems are the development of phage resistance, the instability of biological matrices like milk and serum, anti-phage immune responses, and the lack of harmonized regulatory guidelines for veterinary phage products. New technologies such as liposomal encapsulation, hydrogel delivery, and phage-antibiotic synergy are promising. A recent EU approval of a phage feed additive for poultry is a regulatory milestone. Although they show promise, phage cocktails are still in the investigational stages. They have a significant clinical and public health potential that must be confirmed by increasing multicenter field trials in livestock, well-controlled studies in companion animals, systematic investigations of wildlife reservoirs, standardized dosing, extensive safety testing and regulatory harmonization prior to recommending their routine use in veterinary medicine.
    Keywords:  Bacteriophage cocktail; Biofilms; MRSA; One Health; Staphylococcus aureus; Veterinary phage therapy
    DOI:  https://doi.org/10.1016/j.micpath.2026.108774
  38. Front Endocrinol (Lausanne). 2026 ;17 1891173
    Adjunctive therapies added to standard of care for diabetic foot ulcers: a systematic review and network meta-analysis with pairwise comparisons.
    Wenquan Luo, Ye Sun, Yujie Weng, Kai Huang, Yu Gan.
       Background: Diabetic foot ulcers (DFUs) remain one of the most disabling and costly complications of diabetes. Although standard of care (SOC) is the foundation of DFU management, many ulcers fail to heal adequately, prompting increasing use of adjunctive therapies. However, the comparative effectiveness of different adjunctive strategies remains uncertain.
    Objective: To evaluate and compare the efficacy and safety of adjunctive therapies added to SOC for patients with DFUs using systematic review, pairwise meta-analysis, and network meta-analysis.
    Methods: PubMed, Embase, CENTRAL, Web of Science, ClinicalTrials.gov, WHO ICTRP, and ChiCTR were searched from inception to February 18, 2026. Randomized controlled trials evaluating adjunctive therapies plus SOC for DFUs were included. Interventions were classified into eight clinically interpretable categories: oxygen-based therapies, device-based and physical wound therapies, growth factor and blood-derived therapies, placental and perinatal tissue-derived products, acellular matrix/skin substitute/scaffold products, cell-based and adipose-derived therapies, topical pharmacologic and bioactive agents, and nanotechnology-based, natural product, and bioactive dressing therapies. Outcomes included ulcer area reduction, complete healing, time to healing, adverse events, and amputation.
    Results: Eighty-four randomized controlled trials involving 7,232 participants were included. Compared with SOC alone, several adjunctive therapies improved healing-related outcomes. Device-based therapies, placental products, growth factor/blood-derived therapies, matrix/skin substitute products, and oxygen-based therapies were associated with greater ulcer area reduction. Oxygen-based therapies, matrix/skin substitute products, device-based therapies, placental products, topical pharmacologic/bioactive agents, and growth factor/blood-derived therapies increased the likelihood of complete healing. Cell-based/adipose-derived therapies, growth factor/blood-derived therapies, and matrix/skin substitute products shortened time to healing. Most adjunctive therapies did not increase adverse events, while placental products were associated with a lower risk of adverse events. Oxygen-based and growth factor/blood-derived therapies showed potential reductions in amputation risk, although the evidence was limited.
    Conclusions: Adjunctive therapies added to SOC may improve healing outcomes in patients with DFUs, but their benefits vary across clinical endpoints. Oxygen-based therapies, device-based therapies, placental products, growth factor/blood-derived therapies, and matrix/skin substitute products showed the most consistent potential benefits. Nevertheless, heterogeneity, sparse networks, variable certainty of evidence, and limited direct comparisons preclude a definitive treatment hierarchy. High-quality randomized trials with standardized outcome definitions and adequate follow-up are needed to clarify the optimal use of adjunctive therapies in DFU management.
    Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261385489.
    Keywords:  adjunctive therapy; diabetic foot ulcer; network meta-analysis; standard of care; systematic review; wound healing
    DOI:  https://doi.org/10.3389/fendo.2026.1891173
  39. Crit Rev Microbiol. 2026 Aug 08. 1-19
    Bacterial outer membrane vesicles in oral diseases: from pathogenic mediators to theranostic platforms.
    Yuluan Bu, Zixin Fan, Lu Li.
      Bacterial outer membrane vesicles (bOMVs) are nanoscale structures derived from Gram-negative (G-) bacteria that play an important role in oral diseases. As key mediators of host-microbe interactions, bOMVs contribute to the pathogenesis of periodontitis, oral squamous cell carcinoma (OSCC), and oral lichen planus (OLP) by disrupting immune homeostasis and promoting tissue destruction. Beyond the oral cavity, bOMVs serve as critical vectors in the oral-systemic axis, disseminating virulence factors to distant organs and contributing to atherosclerotic cardiovascular diseases (ACVDs), Alzheimer's disease (AD), and gastrointestinal (GI) disorders. Concurrently, their inherent properties, including cargo-loading capacity, immunogenicity, and biofilm penetration, position them as promising platforms for noninvasive diagnostics and targeted therapeutics. This review systematically integrates current knowledge on bOMVs biogenesis, pathogenic mechanisms in oral and systemic diseases, and emerging applications in diagnosis and treatment. We also highlight key challenges and future directions for translating bOMVs-based strategies into clinical practice, emphasizing their potential as next-generation theranostic tools (combining therapeutic and diagnostic functions) for oral diseases.
    Keywords:  Bacterial outer membrane vesicles; oral bacteria; oral diseases; periodontitis
    DOI:  https://doi.org/10.1080/1040841X.2026.2713518
  40. J Pharm Bioallied Sci. 2026 Jul-Sep;18(3):18(3): 221-223
    Pharmacotherapeutic Evaluation of Topical Insulin Versus Medicinal Honey Dressing in the Management of Diabetic Foot Ulcers among Patients with Diabetes Mellitus: A Randomized Controlled Trial.
    K Chandramathi, B Tamilarasi, P Padmavathi.
       Background: Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus and a major cause of morbidity and lower limb amputation. Effective pharmacological interventions that enhance wound healing are essential for DFU management. Topical insulin has been shown to promote cellular proliferation and angiogenesis, whereas medicinal honey possesses antimicrobial, anti-inflammatory, and tissue regenerative properties.
    Objective: To compare the effectiveness of topical insulin therapy and medicinal honey dressing in promoting wound healing among patients with DFU.
    Methods: A randomized controlled superiority trial with a four-group pre-test and post-test design was conducted among 120 patients with Wagner grade I and II DFU. Participants were allocated into four experimental arms (n = 30 each). Experimental arms I and III received topical insulin dressing, whereas experimental arms II and IV received medicinal honey dressing. Wound healing was evaluated using the Bates-Jensen Wound Assessment Tool (BWAT) before and after intervention.
    Results: Both interventions significantly improved wound healing scores (P < 0.001). In the insulin groups, the paired t-test values were 16.91 and 15.91, while the honey dressing groups showed greater improvement with t-values of 22.35 and 28.17. The post-test mean wound scores were significantly lower in the honey dressing groups compared to the insulin groups, indicating enhanced healing.
    Conclusion: Both topical insulin and medicinal honey dressing are effective pharmacological adjuncts for DFU management. However, medicinal honey dressing demonstrated superior efficacy in promoting wound healing among patients with diabetes mellitus.
    Keywords:  Diabetic foot ulcer; medicinal honey; pharmacotherapy; randomized controlled trial; topical insulin therapy; wound healing
    DOI:  https://doi.org/10.4103/jpbs.jpbs_89_26
  41. Front Cell Infect Microbiol. 2026 ;16 1887826
    Oral microbiome contribution in colorectal carcinogenesis: polymicrobial interactions and virulence determinants.
    Evgeniya Glazunova, Lidiia Astakhova, Alexander Kurnosov, Yuriy Doludin, Alexey Lyundup, Andrey Kostin, Valentin Makarov, Sergey Yudin, Olga Zlobovskaya.
      The contribution of the microbiome to sporadic colorectal cancer (CRC) has traditionally been interpreted through the detection of individual tumor-enriched taxa or isolated virulence factors. However, accumulating evidence indicates that CRC-associated microorganisms often act as structured polymicrobial consortia rather than as independent agents. This review proposes an expanded ecological framework for understanding the role of oral taxa in colorectal carcinogenesis. Oral bacteria, including genera Fusobacterium, Parvimonas, Peptostreptococcus, Porphyromonas, Prevotella, Streptococcus, and related taxa, may translocate to the colorectal niche through enteral or hematogenous routes and establish tumor-associated communities that partially recapitulate the structural organization and succession patterns of oral biofilms. Within these communities, Fusobacterium nucleatum serves as the primary bridging organism, facilitating interspecies adhesion and spatial organization. Parvimonas micra, Porphyromonas gingivalis, and Candida albicans display potential bridging structural and functional properties, with their roles in cooperative pathogenicity and tumor progression supported by substantial experimental evidence. We integrate three complementary conceptual frameworks: oral microbial complexes (gut co-abundance groups), bridging organisms and the extended driver-passenger model of CRC. This synthesis supports a shift from taxonomy-centered interpretation toward a functional virulome-based view, in which the role of a taxon is defined by its ecological position, interaction network, and virulence determinants. Key oral virulence factors contribute to biofilm formation, epithelial adhesion and invasion, barrier disruption, immune evasion, inflammatory modulation, metabolic remodeling of the tumor microenvironment, and metastatic potential. Because the composition of translocated oral consortia changes gradually within the colorectal niche, successive consortium members and their associated virulence determinants may serve as indirect microbial signatures of CRC progression. Recognizing CRC-associated oral communities as structured, interactive ecosystems has important diagnostic and therapeutic implications. Simultaneous detection of pathobionts, their cooperative clusters, and functionally relevant virulence determinants may improve microbiome-based risk stratification. Moreover, targeted disruption of bridging functions, interspecies interactions, or virulence factor activity may offer a precision strategy to weaken carcinogenic consortia without broad, dysbiosis-promoting antimicrobial pressure.
    Keywords:  CRC diagnosis; biofilm; biomarkers; bridge species; colorectal cancer; human oral pathobionts; polymicrobial Interactions; virulence factors
    DOI:  https://doi.org/10.3389/fcimb.2026.1887826
  42. Mil Med Res. 2026 ;13(1): 100058
    Chinese expert consensus on wound repair of venous leg ulcers (2025 edition).
    Wound Repair Professional Committee of Chinese Medical Doctor Association
      Venous leg ulcers (VLUs) result from a multifactorial interplay of etiological factors, posing significant challenges in clinical management. Effective treatment requires a comprehensive assessment to identify the underlying pathophysiological mechanisms, followed by the implementation of an individualized, multidisciplinary approach that integrates the expertise of vascular surgeons, wound care specialists, and other pertinent healthcare professionals. Although both domestic and international vascular surgery societies, as well as other relevant specialties, have issued consensus statements on the diagnosis and treatment of VLUs or clinical guidelines for managing chronic lower extremity venous diseases, there remains a notable gap in systematic guidance specifically focused on wound repair for VLUs. In particular, standardized protocols for surgical wound repair are either lacking or insufficiently detailed in these documents. With the establishment and advancement of wound repair as a specialized field in China, Chinese experts have accumulated substantial clinical experience in the diagnosis and management of VLU-related wound healing. To standardize the surgical repair of VLUs and improve both therapeutic outcomes and patients' quality of life, the Wound Repair Professional Committee of the Chinese Medical Doctor Association convened a panel of multidisciplinary experts for extensive deliberations. Based on a synthesis of current international and domestic evidence and clinical practice, the committee reached consensus on evidence-based recommendations for key issues in VLU wound management, including debridement techniques, indications, timing, and approaches to wound repair for VLUs. This consensus is intended to serve as a practical reference for clinicians involved in the care of patients with VLUs.
    Keywords:  Debridement; Expert consensus; Flap transplantation; Skin grafting; Venous leg ulcers; Wound repair
    DOI:  https://doi.org/10.1016/j.mmr.2026.100058
  43. J Wound Care. 2026 Aug 02. 35(8): 691-699
    Exploring nursing students' first clinical experiences with patients with hard-to-heal wounds in Türkiye: a focus group study.
    Burcu Duluklu, Fatma Cebeci.
       OBJECTIVE: To explore the experiences of undergraduate nursing students in Türkiye participating in their first clinical practice in the wound care unit.
    METHOD: This focus group study used a descriptive phenomenological design. Nursing students were interviewed using a purposive sampling method in three focus groups which took place between 1-31 August 2022. The interviews were conducted online using a semi-structured interview guide. Data were analysed using Colaizzi's seven-step methodology and reported via the Consolidated Criteria for Reporting Qualitative Research checklist.
    RESULTS: The mean age of the 18 participants was 21.2±0.6 years. The most common type of hard-to-heal (chronic) wound type observed by the students was pressure injury, while the most common wound care practice they observed was wound photography. From the analysis of the responses to the interviews, three main themes (consisting of 10 subthemes) emerged: issues that are challenging to cope with (witnessing pain, fear, sadness, incompetency, strain); gains (awareness, self-confidence, role-modelling, transferring theoretical knowledge to clinical practice); and factors that reduce the effectiveness of clinical practice (insufficient time).
    CONCLUSION: In specialised clinics, such as wound care units, providing supportive learning environments for students who find the problems encountered in clinical practice challenging to deal with is essential. Therefore, the theoretical and clinical scopes of educational curricula should be standardised, and clinical educators should support students as they develop a professional perspective on the challenges they encounter.
    Keywords:  clinical practice; education; nursing care; nursing student; wound; wound care; wound dressing; wound healing
    DOI:  https://doi.org/10.12968/jowc.2024.0446
  44. Redox Biol. 2026 Aug 05. pii: S2213-2317(26)00339-3. [Epub ahead of print]96 104340
    S-Nitrosothiols modulate Porphyromonas gingivalis virulence.
    Tsian D Ramrattan, Evan R Stair, Shreya Dandu, Robert L Morgan, Rajnish Kumar, Quincy K Snyder, Leslie M Hicks, Ronit Freeman, Mark H Schoenfisch.
      Porphyromonas gingivalis is the key etiological pathogen of periodontal disease, a chronic oral inflammatory condition that affects over 14% of the global population. P. gingivalis possesses several potent virulence factors-including gingipains, hemagglutinins, and fimbriae-that drive microbial dysbiosis. To restore homeostasis, nitric oxide (NO) is endogenously produced by immune cells to eliminate the infection, but disease persistence necessitates the use of therapeutic agents. The multiple antibacterial mechanisms of NO minimize the potential for antimicrobial resistance compared to traditional antibiotics, making exogenous NO delivery a potential attractive strategy for combating P. gingivalis. The objective of this study was to evaluate the effect of exogenous NO on the virulence of P. gingivalis, including NO's capacity to influence biofilm formation and dispersion, gingipain activity and production, invasion of host cells, and mitigation of immune responses. Nitric oxide effectively modulated the virulent behavior of anaerobic P. gingivalis via transnitrosylation and nitrosative stresses, reducing the pathogen's ability to form biofilms and gingipain activity. Within the anaerobic niche, NO exposure alters the pathogen's ability to export gingipains, thereby significantly reducing its potential to invade host cells and evade the immune system. This work highlights the therapeutic potential of exogenous NO as a promising therapeutic to alter periodontal disease through its multimodal effects on the virulence of P. gingivalis.
    Keywords:  Nitric oxide; Periodontal disease; Porphyromonas gingivalis; Virulence
    DOI:  https://doi.org/10.1016/j.redox.2026.104340
  45. J Gen Virol. 2026 Aug;107(8):
    Isolation and characterization of two phages infecting Acinetobacter baumannii and their effectiveness in treating BALB/c mice lung infections.
    Zeshan Zeshan, Shafia Maryam, Aqsa Jabeen, Sadia Faheem, Rehan Zafar Paracha, Fazal Adnan, Muhammad Faraz Bhatti, Hussnain Ahmed Janjua.
      Acinetobacter baumannii has raised significant concern due to its high rates of morbidity and mortality, coupled with its increasing resistance to multiple antibiotics including carbapenems. In this current study, two new lytic phages Srynta and Nolivar were isolated from sewage water, characterized in vitro and their therapeutic potential was assessed using a mouse model of pneumonia. In vitro results showed that both phages show efficient adsorption to the propagating host, have good lytic activity, short latent period and high burst size. Sequence analysis showed that Srynta and Nolivar phages have linear dsDNA genomes of 45,218 and 41,230 base pairs with G+C content of 38 mol% and 37.9 mol% and contain 88 and 83 coding sequences, respectively. Transmission electron microscopy showed the icosahedral capsid and contractile tail of the phages and genomic analysis predicted that both phages have myovirus morphology and belong to the class Caudoviricetes. Genomic analysis suggested the therapeutic safety of these phages, as they do not have bacterial virulence factors, antimicrobial resistance genes or lysogenic genes, suggesting that they are potential candidates for phage therapy. The in vivo study demonstrated a high survival rate in the phage cocktail treatment group compared to the control group. Our findings support the potential application of phage therapy as an alternative therapeutic treatment against lung infections caused by carbapenem-resistant A. baumannii.
    Keywords:  Acinetobacter baumannii infections; BALB/c mouse models; genome sequencing; phage cocktail; phages
    DOI:  https://doi.org/10.1099/jgv.0.002307
  46. Front Microbiol. 2026 ;17 1791577
    Antibiotic resistance in Pseudomonas aeruginosa: mechanisms, diagnostic challenges, and omics-based diagnostic solutions.
    Md Siddiqur Rahman, Catherine A Wakeman.
      Pseudomonas aeruginosa is considered a multidrug resistant opportunistic pathogen associated with severe infections in immunocompromised patients. Owing to its diverse intrinsic and adaptive resistance strategies, as well as its capacity for horizontal gene transfer, P. aeruginosa represents a major contributor to the global antimicrobial resistance burden. Its remarkable ability to evade antibiotics arises from a wide range of mechanisms, including efflux pumps overexpression, porin modification, enzymatic inactivation and target site modifications, alongside phenotypic adaptations such as biofilm and persister cell formation. These complex resistance strategies of the organism have fueled the global emergence of multidrug resistant, extensively drug resistant and even pan drug resistant strains. These strains significantly complicate the treatment strategies. Conventional culture-based diagnostics are still considered the gold standard, yet their delays and limitations in detecting heteroresistance and biofilm-associated tolerance hinder timely therapeutic intervention. Recent advances in omics-based approaches, including genomics, epigenomics, transcriptomics, proteomics, lipidomics, metabolomics, and phenomics, provide powerful alternatives for rapid and precise identification of resistant P. aeruginosa. In parallel, innovative diagnostic platforms such as microfluidic lab on chip systems and machine learning driven artificial intelligence further enhance diagnostic resolution. Therefore, multi omics integration, coupled with advanced platforms would be a revolutionary strategy to deliver comprehensive and rapid resistance profiling in precision diagnostics. To convert this potential into practice, proper planning, standardized protocols, clinical validation and cost-effective implementation are urgently needed. Together, these advancements pave the way toward outpacing resistance in P. aeruginosa and reducing the global burden of antimicrobial resistance.
    Keywords:  Pseudomonas aeruginosa; antimicrobial resistance (AMR); diagnostics; machine learning (ML); microfluidic lab on chip; multi omics integration; multidrug resistant (MDR); precision therapeutics
    DOI:  https://doi.org/10.3389/fmicb.2026.1791577
  47. J Dent. 2026 Aug 04. pii: S0300-5712(26)00618-4. [Epub ahead of print] 106948
    Salivary and Gingival Crevicular Fluid Extracellular Vesicles in Periodontal Diseases.
    Paras Ahmad.
       OBJECTIVES: This review synthesizes current biomarker-mediated, mechanistic, and clinical evidence on extracellular vesicles (EVs) derived from saliva and gingival crevicular fluid (GCF) as potential diagnostic and functional regulators in periodontal diseases (PD).
    DATA: Preclinical and clinical studies assessing EV-related molecular signatures, biological functions, and diagnostic utilities in PD were included without restriction on publication date.
    SOURCES: Scopus, Web of Science, and PubMed databases were searched.
    STUDY SELECTION: A narrative-scoping approach was adopted to integrate heterogeneous evidence. Findings were synthesized qualitatively owing to variability in methodologies, EV isolation methods, and analytical systems.
    CONCLUSION: Growing evidence supports salivary and GCF EVs as robust, non-invasive biomarkers capable of capturing real-time PD activity. EV payload reflects host-microbial interplay, immune-inflammatory signaling, and tissue remodeling mechanisms, with salivary EVs offering oral and systemic understanding, and GCF-EVs providing site-specific resolution closely linked with clinical parameters. Beyond diagnostic significance, selected EV components exhibit potential mechanistic roles in PD pathogenesis, indicating a dual function as biological mediators and biomarkers. Nevertheless, existing literature remains mainly associative, restricted by small sample size, methodological variability, and lack of standardized methods. Future research should prioritize longitudinal designs, large-scale validation, and integrated multi-omics strategies to allow predictive modeling and clinical application.
    CLINICAL SIGNIFICANCE: Salivary and GCF EVs allow real-time, non-invasive PD identification and monitoring, outperforming conventional approaches that reflect past injury. Their systemic and site-specific insights facilitate early diagnosis, prognosis, and personalized therapy, while clinical adoption mandates standardization and large-scale validation.
    Keywords:  Biofluids; Biomarkers; Exosomes; Gingivitis; Periodontitis
    DOI:  https://doi.org/10.1016/j.jdent.2026.106948
  48. Int J Mol Sci. 2026 Aug 04. pii: 6997. [Epub ahead of print]27(15):
    Healing the Sole: Combining Natural Plant Extracts and Conventional Drugs in Wound Delivery Systems for Diabetic Foot Ulcer Treatment.
    Raneille Quirsten Baligod, Izliah Grace Nicole Fabian, Kristine Margreth Repol, Heidi Lindt Sy, Jubert Marquez, Joseph Rey Sta Agueda.
      Diabetic foot ulcers (DFUs) affect 19-34% of diabetic patients with a five-year mortality rate of 50-70%. It is characterized by a high infection risk, chronic inflammation, oxidative stress, and poor angiogenesis, rendering existing therapies inadequate, which causes antimicrobial resistance and amputations. Bioactive compounds, such as curcumin, flavonoids, tannins, polyphenols, and proteins, found in natural product extracts (NPEs) have antibacterial, anti-inflammatory, antioxidant, and regenerative properties but are prone to variability and instability. Conventional drugs can be applied for targeted infection management and metabolic modulation, but lack regenerative capacity. The combined and synergistic potential of these two agents has not received much attention, especially when integrated into advanced drug delivery systems (DDSs), such as microneedles, hydrogels, nanofibers, and smart bandages. This review discusses NPEs, conventional drugs, combinations, and integration into DDSs, based on wound characteristics. These include depth, infection status, exudate level, and perfusion, as recommended by the 2023 IWGDF guidelines. Three combinations have shown promise in preclinical studies: propolis-charcoal bandages, propolis-oregano microneedles, and Centella-ZnO nanocomposites. However, none have yet been validated in clinical settings, and barriers to clinical adoption persist-standardization, stability, and regulatory issues. This work aims to pave the way for more accessible, sustainable, and efficacious DFU therapeutics by bridging natural and conventional approaches.
    Keywords:  bioactive dressings; biomaterials; chronic wounds; drug delivery; phytochemicals; wound healing
    DOI:  https://doi.org/10.3390/ijms27156997
  49. Clin Infect Dis. 2026 Aug 08. pii: ciag481. [Epub ahead of print]
    Infectious Diseases Society of America 2026 Guidance on the Treatment of Antimicrobial-Resistant Gram-Negative Infections.
    Pranita D Tamma, Robert A Bonomo, Emily L Heil, Julie Ann Justo, Michael J Satlin, Amy J Mathers.
       BACKGROUND: The Infectious Diseases Society of America (IDSA) is committed to delivering timely, evidence-informed guidance on the management of antimicrobial-resistant (AMR) infections. This updated IDSA AMR Guidance document provides treatment suggestions for infections caused by extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E), AmpC β-lactamase-producing Enterobacterales (AmpC-E), carbapenem-resistant Enterobacterales (CRE), Pseudomonas aeruginosa with difficult-to-treat resistance (DTR P. aeruginosa), carbapenem-resistant Acinetobacter baumannii (CRAB), and Stenotrophomonas maltophilia. This update replaces earlier versions of the IDSA AMR Treatment Guidance.
    METHODS: A panel of six infectious diseases specialists with expertise in AMR convened to address important questions regarding the treatment of infections due to ESBL-E, AmpC-E, CRE, DTR P. aeruginosa, CRAB, and S. maltophilia. Given geographic variability in AMR epidemiology and antibiotic availability, the IDSA AMR Guidance focuses on clinical practice in the United States.
    RESULTS: Preferred and alternative treatment strategies are outlined with accompanying rationales, based on pathogen identification and in vitro susceptibility data. Suggestions addressing empiric therapy, transition to oral therapy, duration of treatment, and other management considerations are briefly discussed. While applicable to both adult and pediatric populations, specific dosing guidance is only provided for adults.
    CONCLUSION: The field of AMR is highly dynamic. This document is current as of March 1, 2026 and will be updated periodically. The most up-to-date version of this document, including date of publication, is available at www.idsociety.org/practice-guideline/amr-guidance/.
    Keywords:   Pseudomonas aeruginosa ; Stenotrophomonas maltophilia ; AmpC; CRAB; ESBL; carbapenem-resistant Enterobacterales
    DOI:  https://doi.org/10.1093/cid/ciag481
  50. Front Public Health. 2026 ;14 1821168
    Pathogen characteristics and pre-index clinical factors associated with multidrug-resistant organism infections in intensive care unit patients.
    Xiao-Ju Ma, Meng-Ning Chen.
       Background: Multidrug-resistant organism (MDRO) infections remain a major cause of healthcare-associated morbidity in intensive care units (ICUs). Local characterization of pathogen profiles and clinical factors associated with MDRO infection is needed to inform infection prevention and antimicrobial stewardship strategies.
    Methods: This single-center retrospective observational study included consecutive adult ICU admissions from January to December 2025 with an ICU length of stay ≥48 h and available microbiological cultures. MDRO infection was defined according to clinical infection criteria and phenotypic non-susceptibility to at least one agent in ≥3 antimicrobial categories. A 1:2 propensity score matching approach was used to reduce baseline imbalance. Univariable and multivariable logistic regression analyses were performed to identify pre-index clinical factors associated with MDRO infection, and model discrimination was assessed using receiver operating characteristic (ROC) analysis.
    Results: Among 986 eligible patients, 103 developed MDRO infection, yielding an incidence of 10.4%, with a median onset of 6 days after ICU admission. MDRO infections were mainly ventilator-associated/hospital-acquired pneumonia and bloodstream infection. Carbapenem-resistant Acinetobacter baumannii, carbapenem-resistant Enterobacterales, and carbapenem-resistant Pseudomonas aeruginosa were the predominant phenotypes. In the matched cohort (n = 309), pre-index clinical factors independently associated with MDRO infection included Acute Physiology and Chronic Health Evaluation II score (adjusted odds ratio [aOR] 1.04), pre-ICU antibiotic exposure (aOR 1.58), pre-index ICU carbapenem exposure (aOR 1.92), total pre-index systemic antibiotic duration in ICU (aOR 1.11 per day), pre-index mechanical ventilation (aOR 2.06), pre-index continuous renal replacement therapy (aOR 1.69), procalcitonin (aOR 1.39), and albumin (aOR 0.93). The model showed good discrimination, with an area under the ROC curve of 0.836 and a bootstrap-corrected value of 0.821.
    Conclusion: MDRO infections occurred in approximately one-tenth of ICU admissions and were primarily Gram-negative respiratory and bloodstream infections. Illness severity, pre-index antimicrobial exposure intensity and duration, pre-index organ support, and early inflammatory or nutritional biomarkers were independently associated with MDRO infection. These findings may support preliminary ICU risk stratification, but prospective validation and formal time-dependent exposure assessment are warranted.
    Keywords:  antimicrobial resistance; intensive care unit; logistic regression; multidrug-resistant organism; propensity score matching
    DOI:  https://doi.org/10.3389/fpubh.2026.1821168
  51. Clin Microbiol Infect. 2026 Aug 08. pii: S1198-743X(26)00430-1. [Epub ahead of print]
    From bedside queries to complex care: AI for decision-making in infectious diseases.
    Fabio Borgonovo, Flavia Pennisi, Francesco Petri, Claudia Recanatini, Andrea Gori, Elie F Berbari.
       BACKGROUND: Infectious Diseases require rapid decisions based on heterogeneous and evolving clinical data. At the same time, the shortage of infectious diseases specialists continues to widen the gap between demand for expertise and its availability. Artificial intelligence (AI) has emerged as a potential support tool, although its role in routine care remains uncertain.
    OBJECTIVES: To review current and emerging applications of AI in infectious disease decision-making and to examine their clinical relevance, limitations, and implementation challenges.
    SOURCES: Recent literature was identified through searches of PubMed/MEDLINE, Scopus, Web of Science and Google Scholar, complemented by manual screening of references from relevant articles on AI applications in infectious diseases.
    CONTENT: AI applications in infectious diseases span three main areas of clinical decision-making. Large language models can assist with knowledge retrieval and support routine diagnostic and management questions. Machine learning models are primarily used for risk stratification, identifying patients at risk of clinical deterioration, antimicrobial resistance, or infection recurrence, with potential implications for triage and early intervention. AI-supported therapeutic tools focus on empiric antibiotic selection, antimicrobial stewardship, and dose optimization.
    IMPLICATIONS: AI is best viewed as a decision-support layer that may extend specialist expertise and improve consistency of care. Its clinical adoption, however, depends on external validation across settings, integration within existing workflows, and continued clinician oversight.
    Keywords:  Antimicrobial Stewardship; Clinical Decision Support; Infectious Diseases; Machine Learning; artificial Intelligence
    DOI:  https://doi.org/10.1016/j.cmi.2026.08.002
  52. Npj Viruses. 2026 Aug 11. pii: 38. [Epub ahead of print]4(1):
    Mechanistic insights into phage dynamics to overcome intracellular bacterial reservoirs in urinary tract infections.
    Simone C Lieberknecht-Jouy, Dajana Pavlovic, Carmen Aguilar, Simon Peters, Lucas J Fein, Mathias Müsken, Tobias Weirauch, Annika Y Classen, Olaf Tyc, Silvia Würstle, Thomas A Wichelhaus, Maria J G T Vehreschild.
      Recurrent urinary tract infections frequently arise from uropathogenic bacteria invading bladder epithelial cells, where they establish persistent intracellular reservoirs. Phages represent a promising therapeutic alternative to antibiotics owing to their host specificity, ability to circumvent antibiotic resistance, and capacity to disrupt biofilms. In this study, we investigated whether lytic phages can gain access to human bladder epithelial cells and are able to target internalized bacteria using an in vitro bladder infection model. We show that phages can enter the bladder epithelium either via direct cellular uptake or through co-invasion with extracellularly infected bacteria. Notably, the presence of extracellular uropathogenic Escherichia coli (UPEC) substantially enhanced intracellular phage uptake, revealing a previously unrecognized bacteria-assisted pathway for intracellular phage delivery that may facilitate access to intracellular bacterial reservoirs. Phage treatment prevented epithelial infection by UPEC and preserved urothelial cell integrity. Moreover, phages reduced intracellular bacterial burden, although complete eradication was not achieved and efficacy was limited to early stages of infection. Together, these findings advance understanding of phage-pathogen-human interactions to optimize phage-based strategies for recurrent urinary tract infections.
    DOI:  https://doi.org/10.1038/s44298-026-00222-4
  53. ACS Infect Dis. 2026 Aug 14. 12(8): 2763-2777
    Clinically Relevant Altered Antibiotic Responses and Mechanisms of β-Lactam Sensitization of MRSA in Cystic Fibrosis Artificial Sputum.
    Tyler J Hamelin, Ali Molaeitabari, Marc R MacKinnon, Tanya E S Dahms, Omar M El-Halfawy.
      Staphylococcus aureus is the most common bacterial pathogen affecting pediatric patients with cystic fibrosis (CF), a genetic disorder that causes thick mucus buildup in the lungs, providing a scaffold for chronic infections. Antibiotic treatment is typically guided by standard in vitro antimicrobial susceptibility testing (AST) in Mueller-Hinton broth (MHB), which does not represent the infection site in CF lungs. Notably, discordances between AST predictions and antibiotic therapeutic outcomes have been reported in up to 50% of CF cases. To address this gap, we conducted ASTs against methicillin-resistant S. aureus (MRSA) in CF sputum-mimetic media compared with MHB, demonstrating ≥ 4-fold discordances across four of nine antibiotic classes. Most significantly, we observed unexpected β-lactam sensitization of MRSA strains (up to 128-fold) in CF sputum-like media, crossing the clinical breakpoint, suggesting this shift may alter therapeutic outcomes. Genome-wide screens and follow-up assays revealed underlying cell envelope remodeling and alterations to cell envelope stress responses. On the other hand, mucin binding to daptomycin may have led to an apparent 8-fold increase in resistance to this antibiotic in one of the CF sputum-like media. Overall, our AST results in CF sputum-mimetic conditions provide insights into bacterial responses during CF infections. Importantly, they suggest β-lactams may be effective in treating MRSA infections in CF patients, warranting further investigation in relevant in vivo systems.
    Keywords:  Antimicrobial susceptibility testing; Cell envelope remodeling; Cystic Fibrosis; Host-mimetic conditions; MRSA; β-lactams
    DOI:  https://doi.org/10.1021/acsinfecdis.6c00319
  54. Front Bioeng Biotechnol. 2026 ;14 1820001
    Strengthening global biosecurity for synthetic nucleic acid technology: from sequence screening to risk-based governance in the AI era.
    Sebunya Emmanuel Kato, Abigarl Ndudzo, Sarah Olivia Bayiga, Namugamba Brenda, Charity Serwaa, Erikan Baluku, Hazvinei Mang'anda, Joseph Jacob Peter, Kisuule Shamirah, Mweine Perez, Rosemond Nyatefe Tawiah, Simon Anguzu, Steven Malemia.
      Synthetic nucleic acid technology has expanded rapidly, reducing the cost, time, and technical barriers associated with DNA and RNA synthesis. Existing governance frameworks have focused mainly on sequence-based screening of synthesis orders and customer verification. Although these measures remain essential, they are no longer sufficient as standalone safeguards in a landscape shaped by AI-assisted biological design, globally distributed synthesis capacity, uneven regulatory implementation, and unclear liability across the design-synthesis-use pathway. Protein language models, generative design tools, and other AI-assisted approaches may expand the sequence design space in ways that are harder to assess through homology-based screening alone. This review examines the current biosecurity architecture for synthetic nucleic acid technology and identifies structural limitations in sequence-centered governance. We propose a systems-based, risk-informed framework organized around four interacting dimensions: design capability, access, governance strength, and liability and attribution clarity. The framework is diagnostic and semi-structured rather than quantitative, and is intended to complement existing screening standards and national regulatory approaches. Building on it, we present a four-tier governance escalation model that links dimension profiles to proportionate policy responses and assigns responsibilities to synthesis providers, research institutions, governments, funders, and international bodies. A worked case study illustrates how the framework can be applied to a plausible governance scenario with growing synthetic biology capacity and uneven oversight. The approach integrates equity and proportionality as governance constraints, supporting biosecurity strengthening without undermining responsible innovation.
    Keywords:  biosecurity governance; global biosecurity; risk governance; sequence screening; synthetic nucleic acid screening
    DOI:  https://doi.org/10.3389/fbioe.2026.1820001
  55. Transbound Emerg Dis. 2026 ;2026(1): e8429457
    Characterization and Therapeutic Potential of a Novel Lytic Bacteriophage vB_Kp_H122 Targeting Multidrug-Resistant Hypervirulent Klebsiella pneumoniae of K57 Capsular Type.
    Cuilong Fan, Qiu Xu, Stefan Schwarz, Yaowei Liu, Susu Du, Xiaofeng Lu, Yuxuan Yuan, Longhua Lin, Shuangyu Xie, Fang Xie, Wanjiang Zhang.
      Klebsiella pneumoniae is an important zoonotic opportunistic pathogen. Of particular concern is the emergence of multidrug-resistant hypervirulent K. pneumoniae (MDR-hvKP), which represents a serious public health threat. Bacteriophage (phage) therapy has emerged as a promising solution to combat antibiotic-resistant K. pneumoniae infections. Here, we characterize a novel lytic phage, vB_Kp_H122, that specifically targets K57 capsular-type MDR-hvKP. vB_Kp_H122 exhibited the characteristic morphology of a siphovirus and demonstrated efficient infection kinetics, with an optimal multiplicity of infection (MOI) of 0.001 and a latent period of ~5 min. It also demonstrated considerable stability across a pH range of 4-11 and at temperatures from 4°C to 50°C, as well as potent activity against K. pneumoniae biofilms. The phage has a linear double-stranded DNA genome of 46,077 bp with a G + C content of 47.61% and belongs to a novel species within the genus Roufvirus. Its genome contained no identifiable genes associated with lysogeny, virulence, or antibiotic resistance, supporting its therapeutic safety. In a mouse infection model, a single dose of vB_Kp_H122 at 2 × 106 PFU significantly reduced bacterial loads in organs, alleviated pathological damage, and provided complete protection against lethal challenge with K57 MDR-hvKP. These findings suggest that vB_Kp_H122 may have potential as an antibacterial candidate against K57 MDR-hvKP isolates.
    Keywords:  Klebsiella pneumoniae; antibiofilm activity; bacteriophage; biological characteristics; genome analysis; phage therapy
    DOI:  https://doi.org/10.1155/tbed/8429457
  56. Healthcare (Basel). 2026 Aug 01. pii: 2340. [Epub ahead of print]14(15):
    Independent Predictors of Major Limb Amputation: A Systematic Review and Meta-Analysis of Adjusted Risk Factors.
    Julian Deisenhofer, Maher Ghandour, Merkur Alimusaj, Andre Lunz, Burkhard Lehner, Axel Horsch.
      Background/Objectives: To identify independent predictors of major amputation using adjusted effect estimates. Methods: PubMed, Scopus, Web of Science, and Cochrane Library were searched from inception to 1 March 2024, alongside grey literature. Studies reporting adjusted predictors of major amputation (at or proximal to the wrist or ankle) were eligible. Adjusted odds ratios (aORs) reported by ≥2 studies were pooled using random-effects models. Results: Forty-two studies were pooled. Markers of clinical severity showed the strongest associations: critical limb ischemia (aOR = 4.60, 95% CI 4.20-5.00), leukocytosis (aOR = 3.42, 1.72-5.13), end-stage renal disease (aOR = 3.19, 2.94-3.44), and Rutherford class ≥ IIb (aOR = 3.16, 1.87-4.45). Moderate associations included chronic kidney disease (aOR = 2.22, 1.68-2.76), current smoking (aOR = 2.21, 2.13-2.28), and several comorbidities (prior bypass surgery, chronic obstructive pulmonary disease, peripheral vascular disease; aORs 1.82-1.92). Sociodemographic factors and diabetes mellitus showed smaller but consistent effects (aORs 1.19-1.64). Lower serum albumin (aOR = 0.58, 0.45-0.70) and statin use (aOR = 0.71, 0.66-0.75) reduced odds. Hemoglobin, modelled per unit increase rather than dichotomised, was unexpectedly associated with increased odds (aOR = 1.59, 1.55-1.63), most plausibly reflecting residual confounding. Heterogeneity was substantial for most predictors (I2 frequently > 80%). Conclusions: To our knowledge, this is the first meta-analysis of major amputation restricted to adjusted estimates across diverse populations and both amputation levels. Ischemic burden and systemic disease severity dominate the risk profile, whereas diabetic foot ulcer, wound depth, wound infection, coronary artery disease, and neuropathy did not retain independent significance after adjustment. Given the observational evidence base and substantial heterogeneity, these findings should inform risk stratification rather than causal inference.
    Keywords:  amputation; diabetic foot; lower extremity; meta-analysis as topic; peripheral arterial disease; risk factors; surgical
    DOI:  https://doi.org/10.3390/healthcare14152340
  57. Adv Sci (Weinh). 2026 Aug 10. e77063
    F-Type Pyocin Versus Phage λ Tail: Conserved Hub, Divergent Fibers.
    Zhiwei Gu, Yufan Xie, Lanxin Wang, Luyan Ma, Xiaofei Ge, Jiawei Wang.
      Bacteriocins are ribosomally synthesized antimicrobial peptides or proteins that offer an alternative to conventional antibiotics against multidrug-resistant pathogens. Phage tail-like bacteriocins (tailocins) are classified into rigid R-type and flexible F-type variants. While R-type pyocins from Pseudomonas aeruginosa are well-characterized, F-type pyocins remain poorly understood, especially with respect to the molecular mechanisms for their Gram-negative bactericidal activity. Here, we report cryo-electron microscopy structures of the F-type pyocin from P. aeruginosa ATCC 15442 at 2.29-3.26 Å resolution, encompassing three modular components: the tail cap, tail tip, and tail fiber. Structural comparisons with bacteriophage λ reveal a conserved tail tip architecture, including the baseplate hub proteins, distal tail protein, tail assembly protein, and tape measure protein. Unexpectedly, we identify three trimeric side fibers that attach not to the distal tail protein, as in canonical systems, but to the α-helical shaft of the central fiber, indicating a previously unrecognized attachment mode. The receptor-binding domain of the side fiber shares structural similarity with LPS-recognizing domains of R-type pyocins. Together, these results define the structural basis of F-type pyocin assembly and host recognition, reveal conserved and unique features relative to phage λ, and provide a framework for engineering tailocins as precision antimicrobials against drug-resistant P. aeruginosa.
    Keywords:  PTLB; bacteriocin; lipopolysaccharide (LPS) recognition; phage tail‐like bacteriocin; pseudomonas aeruginosa; pyocin; tailocin
    DOI:  https://doi.org/10.1002/advs.77063
  58. Front Cell Infect Microbiol. 2026 ;16 1828052
    Pathophysiological and immunological characterization of a murine excisional wound infection model for cutaneous Mycobacterium abscessus infection.
    Yuri Jung, Connor Wood, Joong-Yub Kim, Nakwon Kwak, Taek Soo Kim, Jae-Joon Yim, Siyeon Yang.
       Introduction: Mycobacterium abscessus is an emerging rapidly growing nontuberculous mycobacterium that causes chronic skin and soft tissue infections, but its pathogenic potential remains difficult to assess in vivo because existing animal models do not fully recapitulate localized cutaneous infection.
    Methods: We established a murine excisional wound infection model designed to mimic cutaneous barrier disruption and compared it with conventional subcutaneous inoculation. BALB/c mice were infected with a rough-morphotype clinical isolate or rough-morphotype ATCC 19977, and lesion development, bacterial recovery, histopathology, local cytokine mRNA expression, and serum cytokine/chemokine profiles were assessed at terminal time points.
    Results: Compared with subcutaneous injection, the wound model generated persistent lesions with histopathological features consistent with pyogranulomatous inflammation, including foamy macrophages, multinucleated giant cells, fibroblast proliferation, and localized interferon-gamma (IFNgamma) expression. In the strains tested, the model revealed strain-dependent differences in infection establishment: the clinical isolate produced frequent chronic nodular lesions, whereas roughmorphotype ATCC 19977 showed lower lesion incidence under the same experimental conditions. Local tissue and serum cytokine profiling demonstrated a T helper 1 (Th1)-skewed immune response detectable at both terminal time points, associated with bacterial recovery from infected tissues and detectable splenic bacterial recovery.
    Discussion: These findings suggest that the excisional wound model provides a clinically relevant platform for studying localized cutaneous M. abscessus infection. Further validation using additional clinical isolates and mechanistic studies will be required to define its broader applicability.
    Keywords:  Mycobacterium abscessus; Th1 immune response; cutaneous infection model; nontuberculous mycobacteria; virulence potential
    DOI:  https://doi.org/10.3389/fcimb.2026.1828052
  59. Biomed Mater. 2026 Aug 10.
    Recent advance in multifunctional hydrogels for skin wound care: From material classification and fabrication to therapeutic mechanisms.
    Meijin Yan, Xinyu Li, Wenbo Wu, Wei Zhao, Xiujuan Liu, Tifeng Jiao.
      The skin serves as the primary barrier against external physical damage and microbial invasion. When the skin is compromised, effective wound management becomes essential for maintaining tissue integrity and preventing complications. Although conventional wound dressings provide basic protection, they often fail to meet the complex and dynamic requirements of different stages of wound healing. Owing to their highly hydrated three-dimensional networks, tunable physicochemical properties, and excellent biocompatibility, hydrogels have emerged as promising platforms for advanced wound care. Recent advances in material engineering have enabled hydrogels to integrate multiple therapeutic functions, including hemostasis, antibacterial activity, immunomodulation, antioxidant regulation, angiogenesis promotion, scar reduction, and controlled drug delivery, thereby facilitating coordinated tissue regeneration. This review summarizes recent advances in hydrogel-based wound dressings, including the biological process of skin wound healing, hydrogel material classification, fabrication and crosslinking strategies, and multifunctional hydrogel design. Particular attention is given to the relationship between hydrogel functions and different stages of wound healing, as well as the advantages and limitations of various hydrogel systems. Finally, current challenges related to mechanical properties, clinical translation, large-animal evaluation, and manufacturing standardization are discussed, together with emerging strategies such as stimulus-responsive hydrogels and programmable therapeutic systems for future wound management.
    Keywords:  Crosslinking method; Hydrogel; Skin wound healing; Wound dressing
    DOI:  https://doi.org/10.1088/1748-605X/ae97ce
  60. Infection. 2026 Aug 13.
    Artificial intelligence research in journals indexed in the web of science "infectious diseases" category: a bibliometric analysis, 2016-2025.
    Çağlar Irmak, Ahmet Furkan Süner, İlkay Akbulut, Sabri Atalay.
       PURPOSE: Artificial intelligence (AI) is increasingly being applied in the field of infectious diseases. This study aimed to characterize publication trends, collaboration networks, and thematic patterns among AI-related original articles published between 2016 and 2025 in journals assigned to the Web of Science Core Collection (WoSCC) "Infectious Diseases" category.
    METHODS: A systematic bibliometric analysis was performed using the WoSCC. The query combined AI-related terms (machine learning, deep learning, neural networks, large language models, and allied concepts) restricted to the WoSCC category of "Infectious Diseases" and an English-language filter, yielding 1,252 original articles published between January 2016 and December 2025. Bibliometric computations and visualizations were conducted using the Bibliometrix R package, VOSviewer, and Scimago Graphica. Keyword co-occurrence network analysis and temporal trend mapping were employed to identify thematic clusters and emerging research foci.
    RESULTS: The 1,252 articles were contributed by 9,160 authors from 124 countries across 2,850 institutions and published in 125 journals. Annual output grew more than 30-fold between 2016 and 2025, with 84.7% of all publications appearing in the final five years. The United States and China were the most productive countries and collectively dominated international collaboration networks. Harvard University was the leading institution. Keyword network analysis identified nine distinct thematic clusters. Recent trend analyses reveal a significant shift towards clinical applications, specifically highlighting antimicrobial resistance surveillance and early sepsis prediction as dominant research hotspots.
    CONCLUSION: Scientific production on AI applications in infectious diseases has expanded exponentially over the past decade, catalyzed principally by the COVID-19 pandemic. Sepsis management, antimicrobial resistance, surveillance, and clinical prediction represent the most prominent research themes. These patterns indicate areas of growing scientific attention. This study may help guide future clinical validation and implementation research.
    Keywords:  Antimicrobial resistance; Artificial intelligence; Bibliometric analysis; Infectious diseases; Machine learning; Sepsis
    DOI:  https://doi.org/10.1007/s15010-026-02934-4
  61. Nutrients. 2026 Jul 29. pii: 2465. [Epub ahead of print]18(15):
    The Oral-Gut-Brain Axis in Pediatric Populations: The Implications of Oral Dysbiosis for Systemic Inflammation and Neuroinflammation.
    Angelo Michele Inchingolo, Marco Severino, Grazia Marinelli, Lucia Casamassima, Paola Nardelli, Danilo Ciccarese, Andrea Palermo, Francesco Inchingolo, Alessio Danilo Inchingolo, Gianna Dipalma.
      Background: The oral microbiome plays a fundamental role in maintaining local and systemic health during childhood, a developmental period characterized by dynamic microbial, immune, and neuroendocrine maturation. Increasing evidence suggests that oral dysbiosis may influence gut microbiota composition, systemic inflammation, and neuroinflammatory pathways through the oral-gut-brain axis. Aim: This narrative review aimed to summarize and critically evaluate current evidence regarding the relationship between oral dysbiosis, gut microbial alterations, systemic inflammation, and neurodevelopmental processes in pediatric populations. Methods: A search of the literature was conducted using PubMed, Scopus, and Web of Science, including studies published between January 2016 and April 2026. Eligible studies included randomized controlled trials, observational studies, and reviews investigating at least one component of the oral-gut-brain axis in children or adolescents. Results: Current evidence supports a biological interaction between oral and gut microbiota through microbial translocation and immune-mediated mechanisms. Oral dysbiosis may contribute to gut microbial imbalance, intestinal barrier dysfunction, and systemic low-grade inflammation. Altered gut microbiota has been associated with neuroinflammatory signaling, hypothalamic-pituitary-adrenal (HPA) axis dysregulation, and adverse neurodevelopmental outcomes. Furthermore, pediatric randomized controlled trials suggest that probiotics and synbiotics can modulate oral and gut microbial composition, improve selected inflammatory and immune biomarkers, and reduce salivary cortisol levels. Conclusions: The oral-gut-brain axis represents a promising framework for understanding the systemic consequences of oral dysbiosis during childhood. However, direct evidence integrating oral, intestinal, immunological, and neurodevelopmental outcomes remains limited, highlighting the need for longitudinal and multidisciplinary pediatric studies.
    Keywords:  gut microbiota neuroinflammation; oral dysbiosis; oral–gut–brain axis; pediatric microbiome; probiotics in children; salivary cortisol; systemic inflammation
    DOI:  https://doi.org/10.3390/nu18152465
  62. Arch Microbiol. 2026 Aug 10. pii: 562. [Epub ahead of print]208(11):
    Genomic insights into efflux-mediated biofilm persistence and multidrug resistance in Achromobacter xylosoxidans from cystic fibrosis.
    Bochra Kouidhi, Hajer Rhim, Mehdi Bhouri, Yosr Kadri, Ons Haddad, Maha Mastouri, Ryan Adnan Sheikh, Ehab Mostafa Mohamed Ali, Hicham N Altayeb, Imran Kazmi, Kamel Chaieb.
      Achromobacter xylosoxidans is an emerging opportunistic pathogen related to cystic fibrosis (CF). Its clinical impact is variable among patients depending on strain-specific genomic diversity and interaction with co-infecting pathogens. Hence, genomic analysis plays a key role in understanding its pathogenic potential and adaptation in the CF disease. This study included a clinical strain isolated from sputum of a patient with CF. The strain was evaluated for its antimicrobial susceptibility using VITEK 2 and biofilm formation / inhibition using crystal violet assay in the presence and absence of PAβN. Whole-genome sequencing was conducted using Illumina technology, followed by genome assembly and annotation. The resistome and virulence profiling of MICB25 was achieved using BV-BRC and PGAP pipelines. The clinically strain (MICB25) was identified as Achromobacter xylosoxidans. Our study shows that secretion systems, multidrug efflux systems are functionally linked to biofilm formation in a CF-associated A. xylosoxidans MICB25, as evidenced by PAβN-mediated biofilm inhibition. The whole-genome sequencing revealed a multifaceted resistome including β-lactamases, aminoglycoside-modifying enzymes, and other resistance determinants in addition to an exceptionally broad and varied efflux repertoire covering ABC, MFS, RND, and SMR families. The application of whole-genome sequencing in this study provides crucial insights into the persistence-oriented pathogenic strategy of this emerging CF pathogen A. xylosoxidans. The coexistence of multidrug efflux determinants and PAβN-sensitive biofilm formation suggests that efflux activity could be involved in persistence and warrants addditional mechanistic investigation.
    Keywords:   Achromobacter xylosoxidans ; Antibiotic resistance; Cystic fibrosis; Efflux pumps; Whole-genome sequencing; β-lactamases
    DOI:  https://doi.org/10.1007/s00203-026-05125-9
  63. J Indian Soc Periodontol. 2026 Apr-Jun;30(2):30(2): 221-229
    Multivariate analysis of treatment choices, disease activity, comorbidities, and oral impairments in rheumatoid arthritis patients.
    Anitha Krishnan Pandarathodiyil, Ramya Ramadoss, K Hema Shree, Saranya Chinnadurai, Pratibha Ramani, B Sivapathasundharam.
       Background: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects the synovial joints and is often associated with multiple comorbidities. Emerging evidence suggests a bidirectional link between RA and periodontal inflammation, wherein shared inflammatory mediators contribute to disease severity and therapeutic outcomes.
    Objective: The objective of the study was to examine the relationships among demographic and clinical characteristics, comorbidities, periodontal impairment assessed using Russell's Periodontal Index, systemic disease activity measured by Disease Activity Score (DAS28) and C-reactive protein (CRP), and treatment regimens in patients with RA.
    Materials and Methods: A cross-sectional cohort of 33 patients clinically diagnosed with RA (21 seropositive and 12 seronegative) was analyzed. Demographic, serological, and clinical data were retrieved from medical records and verified during follow-up consultations. Russell's Index was used to quantify periodontal involvement, whereas disease activity was assessed using the DAS28 score, which incorporates CRP levels. Details of comorbidities and prescribed treatments, hydroxychloroquine (HCQ), corticosteroids, or combination therapy, were documented. Descriptive and correlational analyses were performed to evaluate associations between disease activity, oral impairment, and therapeutic approach.
    Results: The cohort comprised 91% females, with a mean age of 46.5 ± 9.8 years. Seropositive RA was identified in 64% of patients. The mean Russell's Index was 2.42 in the RA+ and 1.92 in the RA- groups, showing greater periodontal impairment in seropositive cases. Hypertension (12%), diabetes (6%), and hypothyroidism (6%) were the most frequent comorbidities. Combination therapy (HCQ + steroids) was most commonly prescribed (36%) and associated with higher DAS28 and Russell's scores. A positive correlation was noted between disease activity and periodontal index values.
    Conclusion: Both systemic comorbidities and oral inflammatory burden influence RA severity. Integrating periodontal assessment with systemic disease monitoring enables more precise, personalized therapy selection. Russell's Index, in conjunction with DAS28 and CRP, may serve as a useful adjunctive marker for therapeutic stratification in RA.
    Keywords:  C-reactive protein; Comorbidities; Disease Activity Score-28; Russell’s periodontal index; periodontitis; rheumatoid arthritis; treatment strategy
    DOI:  https://doi.org/10.4103/jisp.jisp_48_25
  64. Clin Cosmet Investig Dermatol. 2026 ;19 619005
    Platelet-Rich Plasma Fibrin Glue Dressing Combined with a Novel Repairing Gel for Healing Recalcitrant Diabetic Foot Ulcers: Findings from an Exploratory Randomized Pilot Trial.
    Elaheh Emadi, Mohammad-Hadi Saeed-Modaghegh, Alireza Mousavian, Hamid Reza Rahimi, Daryoush Hamidi-Alamdari.
       Purpose: Recalcitrant diabetic foot ulcers (DFUs) remain difficult to heal and impose substantial clinical and economic burdens. This exploratory, four-arm, parallel-group randomized pilot trial aimed to evaluate whether combining platelet-rich plasma-fibrin glue (PRP‑FG) with a novel repairing gel enhances healing outcomes in DFUs compared with standard care and single‑agent therapies.
    Patients and Methods: In this study, twenty patients with DFUs unresponsive to at least four weeks of standard treatment were randomized using computer-generated blocks with allocation concealment to receive PRP‑FG alone, repairing gel alone, the combination therapy, or standard care. Allogeneic PRP‑FG was prepared by gradient‑density centrifugation. The repairing gel contained multiple active components, including vitamins A, B3, and C, collagen, glycine, organic acids, sodium alginate, carboxymethyl cellulose, benzoic acid, gentian violet, methylene blue, triethanolamine, bromelain, allantoin, and dimethyl sulfoxide. Wound healing rate over 12 weeks served as the primary outcome, assessed weekly by a blinded evaluator.
    Results: Nineteen patients completed the 12‑week follow‑up. Complete epithelialization occurred in 100% (5/5) of participants receiving the combined therapy, 20% (1/5) of those receiving the repairing gel alone, and 0% (0/5) in the PRP‑FG alone and standard care groups. The combined therapy significantly accelerated ulcer healing compared with all other groups (p < 0.05). These findings are preliminary and derived from a small pilot sample. No serious adverse events were observed.
    Conclusion: This exploratory pilot trial suggests that combined PRP‑FG and repairing gel therapy may promote superior healing of recalcitrant DFUs compared with standard care or single‑agent treatments. Larger, multicenter clinical trials are warranted to validate these preliminary findings.
    Keywords:  diabetic foot ulcers; fibrin; platelet-rich plasma; repairing gel; wound healing
    DOI:  https://doi.org/10.2147/CCID.S619005
  65. Int Forum Allergy Rhinol. 2026 Aug 13.
    Nasal Lavage IL-4 and IL-13 in Cystic Fibrosis-Related Chronic Rhinosinusitis: Associations With Disease Severity and Potential Implications for Targeted Therapies.
    Elisabetta Bigagli, Alberto Minzoni, Luca Mazzetti, Miriam Todaro, Lorenzo Cinci, Cosimo Nardi, Pietro Orlando, Silvia Bresci, Giandomenico Maggiore, Cristina Luceri.
       BACKGROUND: Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and has traditionally been considered a predominantly neutrophilic condition. Emerging evidence, however, suggests that type-2 inflammatory pathways may contribute to disease heterogeneity. Data linking local inflammatory mediators with objective sinonasal disease severity and olfactory dysfunction in CF-associated CRS remain limited.
    METHODS: In this cross-sectional study, 42 adults with CF-associated CRS (22 with nasal polyps and 20 without) underwent assessment of disease severity using the nasal polyp score (Meltzer classification) (NPS-MS), modified Lund-Kennedy score (mLKS), and Lund-Mackay score (LMS), together with olfactory testing (Sniffin' Sticks Identification Test) and quality-of-life evaluation (22-item Sinonasal Outcome Test [SNOT-22]). Nasal lavage concentrations of IL-4, IL-13, and IL-8 were quantified by ELISA.
    RESULTS: IL-4 and IL-13 were significantly associated with objective measures of sinonasal disease severity, including NPS-MS and LMS (all p < 0.05), whereas IL-8 did not show consistent associations with disease severity. In multivariable models, IL-4 remained independently associated with mLKS (p = 0.025), LMS (p = 0.047), and olfactory dysfunction (p = 0.002). IL-13 was primarily associated with NPS-MS (p = 0.007) and LMS (p = 0.005). Lung transplantation modified cytokine-severity relationships. Exploratory analyses showed lower IL-4 levels in elexacaftor/tezacaftor/ivacaftor-treated patients (p = 0.036), with no significant effects for IL-8 or IL-13.
    CONCLUSIONS: CF-associated CRS exhibits a heterogeneous inflammatory profile in which type-2 cytokines, particularly IL-4 and IL-13, are linked to disease severity and olfactory dysfunction. Nasal lavage cytokines may represent promising compartment-specific biomarkers to support inflammatory endotyping and targeted therapeutic strategies.
    Keywords:  biomarkers; cystic fibrosis; cytokines; endotype; nasal lavage; nasal polyps; olfactory dysfunction
    DOI:  https://doi.org/10.1002/alr.70245
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