ANTIBIOTICO RESISTENZA

1. The Role of Helicobacter pylori Heat Shock Proteins in Gastric Diseases' Pathogenesis

   Helicobacter pylori (H. pylori) is a Gram-negative bacterium that colonizes the human stomach and is associated with several gastric diseases, including gastritis, peptic ulcer disease, and gastric cancer. The bacterium's ability to thrive in the harsh gastric environment is due, to some extent, to its stress response mechanisms, with its heat shock proteins (HSPs) playing a putative, yet not fully understood, role in these adaptive processes. HSPs are a family of molecules, highly conserved...

2. Adaptations of Bacterial Extracellular Vesicles in Response to Antibiotic Pressure

   Extracellular vesicles (EVs) are nanometer-sized lipid structures actively secreted by Gram-negative and Gram-positive bacteria, representing a sophisticated microbial adaptation and communication strategy. These structures are involved in biomolecular transport, the regulation of biological processes, the modulation of host-pathogen interactions, and adaptation to hostile environmental conditions. EVs also play a crucial role in virulence, antibiotic resistance, and biofilm formation. This...

3. Antibiotic Prophylaxis After Urethroplasty: A Review of the Literature

   Urethroplasty is a highly effective surgical treatment for urethral stricture disease. While overall complication rates are low, surgical site infections and urinary tract infections (UTIs) represent the most common complications. Due to the prolonged need for catheterization following reconstruction, many urologists place patients on extended antibiotic prophylaxis postoperatively. However, antibiotic stewardship is important given the risks of antibiotic overuse including opportunistic...

4. Efficacy and Safety of Uro-Vaxom in Urinary Tract Infection Prevention: A Systematic Literature Review

   Background/Objectives: Urinary tract infections (UTIs) are the most common bacterial infections and one of the most common diseases worldwide. These infections induce an enormous financial and economic burden. The most frequent pathogen in UTIs is Escherichia coli (E. coli), which is responsible for over 85% of cases of cystitis and over 60% of recurrent cases. Repeated antibiotic prescriptions increase the risk of bacteria developing resistance, reducing treatment efficacy and limiting...

5. Systems thinking to understand the complexity of antimicrobial resistance across One Health: A systematic review of current approaches

   Antimicrobial resistance (AMR) is a significant global threat that affects not only human health but also the health of animals and the environment. The evolution and spread of AMR are driven by a complex set of interconnected factors across all domains of One Health. Effectively addressing this challenge requires systems approaches and collaborative efforts across multiple sectors. We conducted a systematic quantitative literature review to explore the application of systems thinking approaches...

6. A systematic review of the effectiveness and cost-effectiveness of implementing antimicrobial stewardship program at tertiary care facilities in India

   CONCLUSIONS: ASPs in Indian tertiary care settings are clinically effective and economically viable, reducing antimicrobial misuse, curbing resistance, and improving patient outcomes, while lowering health care costs. Further research using standardized metrics and extending to other health care levels is needed to optimize and sustain ASP benefits.

7. Dual threat: Susceptibility mechanisms and treatment strategies for COVID-19 and bacterial co-infections

   COVID-19 has rapidly spread worldwide, posing significant challenges to public health systems. This review offers an in-depth examination of the mechanisms underlying susceptibility and associated clinical features, and treatment strategies associated with bacterial co-infections in COVID-19 patients. A structured review of the literature revealed that the overall rate of bacterial co-infection among COVID-19 patients is relatively low (6.9 %). However, the rate increases significantly in severe...

8. The ladder of regulatory stringency and balance: an application to the US FDA's regulation of bacterial live therapeutics

   The three main types of live bacterial therapies - probiotics, fecal/microbiome transplants, and engineered bacterial therapies - hold immense potential to revolutionize medicine. While offering targeted and personalized treatments for various diseases, these therapies also carry risks such as adverse immune reactions, antibiotic resistance, and the potential for unintended consequences. Therefore, developing and deploying these therapies necessitates a robust regulatory framework to protect...

9. Current economic and regulatory challenges in developing antibiotics for Gram-negative bacteria

   Antimicrobial resistance (AMR) is a serious global threat projected to cause 10 million deaths annually by 2050. Antibiotics are becoming ineffective, leading to poor health outcomes and economic burden. Despite the urgent need, scientific, economic, and regulatory challenges hinder antibiotic development, causing major companies to exit the field. This review explores the AMR crisis, challenges in antibiotic development, particularly for Gram-negative bacteria, and potential solutions to...

10. Treatment and diagnostic challenges associated with the novel and rapidly emerging antifungal-resistant dermatophyte, Trichophyton indotineae

    Trichophyton indotineae is a recently discovered dermatophyte species that causes recalcitrant dermatophytosis. It was first reported from India and has quickly spread across the globe. The exact prevalence of T. indotineae remains unknown due to limited surveillance. It has reached epidemic proportions in the Indian subcontinent. In India, this new species has largely replaced other previously common dermatophytes. Reports from Western countries suggest most cases are imported, with some...

11. Quantifying antimicrobial resistance in food-producing animals in North America

    The global misuse of antimicrobial medication has further exacerbated the problem of antimicrobial resistance (AMR), enriching the pool of genetic mechanisms previously adopted by bacteria to evade antimicrobial drugs. AMR can be either intrinsic or acquired. It can be acquired either by selective genetic modification or by horizontal gene transfer that allows microorganisms to incorporate novel genes from other organisms or environments into their genomes. To avoid an eventual antimicrobial...

12. Regulating periodontal disease with smart stimuli-responsive systems: Antimicrobial activity, immunomodulation, periodontium regeneration

    Periodontal disease is a worldwide inflammatory condition that seriously affects both oral and systemic health. The presence of microbial biofilms and the dysregulation of the host immune response are considered crucial factors in the initiation and progression of periodontal disease. Mechanical debridement combined with antibiotic therapy is the standard non-surgical treatment for periodontal disease; however, this approach faces limitations in deep bacterial clearance and resistance to...

13. A new quadrivalent meningococcal tetanus toxoid conjugate vaccine: Menquadfi® (MENACWY-TT)

    Neisseria meningitidis (Nm) remains a major global health concern, causing invasive meningococcal disease (IMD) with significant morbidity and mortality. Despite vaccination efforts, Nm serogroup prevalence and antibiotic resistance continue to evolve, necessitating ongoing surveillance and novel immunization strategies. This review aims to assess the role of MenACWY-TT, a quadrivalent meningococcal conjugate vaccine, in IMD prevention by evaluating its immunogenicity, safety, and real-world...

14. Unveiling the Therapeutic Potential of Probiotics in Sepsis: A Review

    Sepsis continues to be among the most significant causes of mortality and morbidity globally, as defined by an exaggerated host response to infection resulting in a peak of systemic inflammation, organ dysfunction, and unnecessary mortality. The many complexities of sepsis, such as its pathophysiology, current treatments, and its evolving place within nutrition care, are debated. The major etiologies of sepsis are bacterial, viral, and fungal infections leading to an inappropriate immune...

15. Current understanding of the Streptococcus bovis/equinus complex and its bacteriophages in ruminants: a review

    Streptococcus bovis/Streptococcus equinus complex (SBSEC) comprises eight (sub)species, with several opportunistic pathogenic members. These SBSEC species are associated with metabolic disorders in ruminants, resulting in economic losses to the global livestock industry. Moreover, the emergence of antimicrobial resistance (AMR) in SBSEC strains, particularly against commonly used antibiotics, poses serious concerns to the livestock industry. Therefore, alternative approaches to control SBSEC...

16. The Value of the Galactomannan Test in Diagnosing COVID-19-Associated Pulmonary Aspergillosis: A Review

    COVID-19-associated pulmonary aspergillosis (CAPA) is a complication of COVID-19. Galactomannan (GM) is a non-invasive test used to diagnose invasive aspergillosis. We collected the existing studies on the diagnostic value of GM to determine a GM level for predicting CAPA. All articles on the value of GM in CAPA diagnosis published until November 2023 were reviewed. The main databases were searched using the following keywords: "aspergillus", "aspergillosis", "SARS-CoV-2", "COVID", "2019...

17. Antibiotic use without prescription among children aged under 5 years in low- and middle-income countries: a systematic review and meta-analysis

    CONCLUSIONS: The pooled prevalence of antibiotic use without prescription among under-5 children in LMICs is high. This implies that the WHO in collaboration with the nations should develop different strategies to improve the regulatory system in LMICs and prevent the use of antibiotics without prescription among under-5 children.

18. Nurse prescribing for selected UTIs in Spain: a challenging step forward

    This paper examines the implications of Spain's recent legislative reform enabling nurses to prescribe antibiotics for uncomplicated urinary tract infections (UTIs) in women, positioning it as a critical development in antimicrobial stewardship (AMS) and nursing practice. The paper aims to assess how this policy aligns with international models of nurse prescribing, evaluating its potential to enhance workforce flexibility, and identifying some challenges and opportunities regarding its...

19. Risk factors and outcomes of inadequate empirical antibiotic therapy in ventilator-associated pneumonia: a systematic review and meta-analysis

    CONCLUSIONS: VAP caused by MDR pathogens were highly likely to receive inadequate empirical antibiotic therapy. The mortality rate and intubation duration were significantly longer in inadequately treated VAP as compared to adequately treated VAP.

20. Targeting MRSA penicillin-binding protein 2a: structural insights, allosteric mechanisms, and the potential of adjuvant inhibitors

    Methicillin-resistant Staphylococcus aureus (MRSA) represents a critical global challenge requiring new therapeutic and management strategies. As a major cause of nosocomial infections, MRSA is associated with a high mortality rate owing to its resistance to multiple β-lactam antibiotics. Methicillin resistance is primarily attributed to acquisition of the mecA gene, which encodes penicillin-binding protein 2a (PBP2a). The MecA/PBP2a protein, which catalyzes critical cell wall synthesis steps,...

21. The gut-lung axis and microbiome dysbiosis in non-tuberculous mycobacterial infections: immune mechanisms, clinical implications, and therapeutic frontiers

    Non-tuberculous mycobacteria (NTM) are emerging pathogens of global concern, particularly in regions with declining tuberculosis rates. This review synthesizes current evidence on the epidemiology, immune pathogenesis, and microbiome interactions underlying NTM infections. The rising incidence of NTM is driven by environmental factors, immunocompromised populations, and advanced diagnostics. Clinically, NTM manifests as pulmonary, lymphatic, skin/soft tissue, or disseminated disease, with...

22. Antibiotic potentiators as a promising strategy for combating antibiotic resistance

    Antimicrobial resistance (AMR) poses a critical global health challenge. It arises from pathogens' resistance to antibiotics due to misuse, overuse, and insufficient regulation. As new antibiotics emerge slowly, antibiotic potentiators can enhance existing treatments against resistant strains. Challenges such as toxicity and regulatory barriers necessitate further studies to optimize these agents. This review examines the mechanisms, sources, and recent advancements in antibiotic potentiation...

23. One Health strategies in combating antimicrobial resistance: a Southeast Asian perspective

    Antimicrobial resistance (AMR) is a multifactorial global public health concern that is interlinked with the health of humans, animals, and the environment. Therapeutically important antibiotics used widely in the mass medication of livestock have contributed significantly to AMR, as they eventually enter the environment due to inadequate treatment of wastewater. Similarly, improper discharge of antibiotic-contaminated waste by the medical sector exacerbates the problem by contributing to the...

24. Antibacterial MXenes: An emerging non-antibiotic paradigm for surface engineering of orthopedic and dental implants

    The colonization of planktonic bacteria onto implant surfaces is a serious concern in the medical field due to increasing infection-related mortality and fiscal difficulties worldwide. Various static, dynamic, and active coating techniques were established to tackle implant-associated infections (IAIs). However, the existing implant coating methods often confront issues with poor universality for different substrates, adaptability, stability, and the emergence of multi-drug resistance (MDR). The...

25. Combination strategies of gut microbiota in cancer therapy through metabolic reprogramming and immune remodeling

    Over the past decade, there has been a qualitative improvement in the understanding of gut microbiota in cancer development and treatment. Gut microbiota regulates metabolic reprogramming that occurs in the competition between tumor cells and immune cells for essential nutrients in the tumor microenvironment (TME). Besides, gut microbiota dysbiosis is one of the key factors leading to the formation of aging environment, which has many similarities with the TME. Accumulating research findings...

26. Prevalence and molecular epidemiology of carbapenem resistance in Asia: a systematic review and meta-analysis

    CONCLUSION: The results suggest that surveillance of CR among Asian countries is essential to reduce the burden of antibiotic resistance. Mitigating the impact of CR infections will safeguard the efficacy of carbapenems for future generations and reduce further dissemination of CR genes.

27. 2025 update of the drug resistance mutations in HIV-1

    Certain mutations in HIV-1 that emerge during exposure to antiretroviral drugs may have varied impact on the effectiveness of current and subsequent treatments for HIV. This 2025 edition of the International Antiviral Society-USA (IAS-USA) drug resistance mutations list updates the Figure last published in November 2022 based on new data that have become available. The mutations listed are those that have been identified by specific criteria to contribute to a reduced virologic response to...

28. A Comprehensive Review of the Role of Virulence Factors in Enteropathogenic Escherichia coli-Induced Intestinal Injury

    Escherichia coli (E. coli) is a rod-shaped gram-negative bacterium that includes the diarrheagenic strains, an identical group of intestinal pathogens.E. coli diarrhea is transmitted through the feco-oral route, through contaminated food and water. Enteropathogenic E. coli (EPEC) is one of the leading causes of diarrhea in the pediatric age group in developing and developed countries. Depending on the absence or presence of E. coli adherence factor plasmids, they are classified as typical or...

29. AI in fungal drug development: opportunities, challenges, and future outlook

    The application of artificial intelligence (AI) in fungal drug development offers innovative strategies to address the escalating threat of fungal infections and the challenge of antifungal resistance. This review evaluates the current landscape of fungal infections, highlights the limitations of existing antifungal therapies, and examines the transformative potential of AI in drug discovery and development. We specifically focus on how AI can enhance the identification of new antifungal agents...

30. Global antibiotic hotspots and risks: A One Health assessment

    Antibiotics are increasingly prevalent in global environments, driving antimicrobial resistance and disrupting microbial cycling. These impacts pose threats to human, animal, and environmental health. Therefore, addressing this emergent issue necessitates a One Health framework that integrates these interconnected dimensions. Here we systematically review 137 antibiotics across diverse global environmental compartments. We find that sulfonamides, macrolides, quinolones, and tetracyclines are...

31. Peptide vaccines: an innovative therapeutic approach against antibiotic-resistant bacterial infections

    Bacterial infections continue to pose a serious threat to global health, especially with the growing challenge of multidrug-resistant pathogens. While traditional vaccines have been pivotal in reducing disease burden, they come with limitations such as variable efficacy, safety concerns, and limited ability to address the diversity of bacterial strains. This review highlights the promise of peptide-based vaccines as an innovative approach to overcoming these hurdles. By targeting specific...

32. Prevalence and associated factors of self-medication with antibiotics among pediatric population in India: a systematic review and meta-analysis

    CONCLUSION: Self-medication with antibiotics was prevalent among the pediatric population in India. Therefore, government and policymakers should take necessary measures to promote the responsible use of antibiotics.

33. Evaluating Consumer Perceptions and Safety of Genetically Modified Foods in Africa: A Comprehensive Review

    Technological advances in the food industry have garnered significant attention, particularly for enhancing sustainability and reducing food insecurity in Africa, especially in sub-Saharan regions where several million people are undernourished. This increasing demand for food, coupled with consumers' desire for diversity and safety, has spurred innovations like Genetically Modified Foods (GMF). These programs involve altering the genetic makeup of crops and livestock to improve outcomes such as...

34. The gut microbiome: an emerging epicenter of antimicrobial resistance?

    The human gut is one of the most densely populated microbial environments, home to trillions of microorganisms that live in harmony with the body. These microbes help with digestion and play key roles in maintaining a balanced immune system and protecting us from harmful pathogens. However, the crowded nature of this ecosystem makes it easier for harmful bacteria to acquire antimicrobial resistance (AMR) genes, which can lead to multidrug-resistant (MDR) infections. The rise of MDR infections...

35. Prevalence of HIV drug resistance among patients experiencing first-line treatment failure in Ethiopia: a systematic review and meta-analysis

    CONCLUSIONS: The prevalence rate of HIV drug resistance in Ethiopia is high. This alarms health care workers, programmers and decision makers to consider ways of controlling the emergence of HIV drug resistance and the spread of drug-resistant strains. Timely monitoring of treatment failures, HIV drug resistance testing and switching on appropriate regimen classes are crucial for better treatment outcomes. There was high HIV drug resistance among children but with a high heterogeneity indicating...

36. Targeted nanomedicines for the treatment of Helicobacter pylori infection

    Helicobacter pylori is a significant risk factor for gastric cancer, making its elimination crucial for prevention. This review explores the application of nanotechnology in enhancing treatment efficacy against H. pylori and addressing antibiotic resistance. Nanomaterials are utilized as drug carriers to protect pharmaceuticals from the acidic gastric environment and enable controlled release. These materials can be specifically engineered to target H. pylori surface molecules, thereby improving...

37. Alternative antibiotics for the treatment of bacterial meningitis in children: a systematic review of efficacy and safety

    CONCLUSION: The results suggest that alternatives to standard treatment, such as ampicillin, chloramphenicol, cefuroxime and meropenem, are viable and safe options for the treatment of bacterial meningitis in children. These results help to adapt clinical practices, especially in settings with high antimicrobial resistance and resource limitations, by providing evidence for shorter and equally effective treatment regimens.

38. Prevalence and healthcare burden of inappropriate antimicrobial treatment in patients at high risk of complications from acute respiratory infections: a scoping review

    CONCLUSION: Areas for improving care for this patient population include identifying patients at risk of severe disease and complications from ARIs and following evidence-based protocols for testing, treatment and follow-up to minimize the risk of developing adverse events, antibiotic-resistance, and severe complications.

39. Global prevalence and antibiotic resistance profiles of bacterial pathogens in table eggs: A systematic review and meta-analysis

    CONCLUSION: This study underscores the high global prevalence of pathogenic bacteria in poultry eggs and highlights concerning antibiotic resistance trends, particularly among Salmonella spp. and E. coli. The findings emphasize the urgent need for region-specific biosecurity protocols and antimicrobial stewardship strategies to reduce egg contamination and control antibiotic-resistant pathogens, ultimately safeguarding public health and food safety.

40. Multidrug resistance efflux pump expression in uropathogenic Gram-negative bacteria in organ transplant recipients

    Urinary tract infections (UTIs) are common in healthcare settings and communities; and are predominantly caused by Gram-negative bacteria, which account for > 70% of UTI cases. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa are the most common bacterial agents responsible for UTIs. The emergence of antibiotic resistance poses a challenge for UTI treatment; and efflux pump overexpression contributes to Gram-negative bacterial resistance. This comprehensive review summarizes...

41. Unlocking Enhanced Efficacy of Aminoglycoside Antibiotics Against Pseudomonas aeruginosa

    Infectious diseases continue to be a global health burden. Among the major human pathogens is the Gram-negative bacterium Pseudomonas aeruginosa, which is particularly due to its wide range of drug resistance mechanisms. Aminoglycosides, which have long been used in treating pseudomonal infections, are increasingly undermined by resistance. This opinion article discusses the use and challenges of aminoglycosides against P. aeruginosa and highlights recent strategies that enhance aminoglycoside...

42. Antibiotics re-booted-time to kick back against drug resistance

    After decades of neglect and a decline in antibiotic research and development, we are now finally witnessing the advent of new funding programs dedicated to new therapies. In addition to traditional new chemical entities that directly kill or arrest the growth of bacteria, alternative approaches are being identified and advanced towards proof-of-concept trials in the clinic. We briefly review the current pipeline of conventional new antibiotics and highlight in more depth promising alternatives,...

43. The intersection of the social determinants of health and antimicrobial resistance in human populations: a systematic review

    CONCLUSIONS: This review identified the need to (a) develop policies and context-specific solutions to manage upstream determinants, (b) include population groups where current evidence is limited and (c) prioritise community-based research using co-production methods.

44. Harnessing mushrooms for poultry nutrition: Boosting health, immunity, and productivity

    Edible mushrooms, the fruiting bodies of fungi, are emerging as promising functional feed additives in poultry nutrition, offering a sustainable alternative to synthetic growth promoters. Rich in bioactive compounds such as β-glucans, glycoproteins, polyphenols, terpenoids, and antioxidants, mushrooms exhibit immunomodulatory, antimicrobial, anti-inflammatory, and antioxidative properties. These compounds support enhanced immune function, metabolic regulation, oxidative stress reduction, and...

45. Unraveling the global landscape of Elizabethkingia antibiotic resistance: A systematic review and meta-analysis

    CONCLUSION: This study highlights the widespread antibiotic resistance in Elizabethkingia, underscoring the urgent need for targeted treatment strategies and enhanced surveillance programs. The findings emphasize the importance of monitoring local resistance patterns to guide clinical decision-making. Future research should focus on elucidating resistance mechanisms and genetic diversity to develop practical therapeutic approaches and mitigate the global health impact of Elizabethkingia...

46. Antimicrobial-resistance of Escherichia coli in dogs and cats: A scoping review

    Pathogenic Escherichia coli causes a range of clinical manifestations in dogs and cats, and the use of antimicrobials in pets is associated with the risk of antimicrobial resistance (AMR). Pets contribute to the dissemination of AMR both within their species and to humans. This study conducts a scoping review to assess the existing evidence on the AMR of E. coli in dogs and cats, noting the purpose of antimicrobial susceptibility testing (AST) and determining the knowledge gaps to inform future...

47. Exploiting haem-iron dependence of nontypeable Haemophilus influenzae: an avenue for future therapeutic development

    Nontypeable Haemophilus influenzae (NTHi) is a major respiratory pathogen that imposes a substantial disease burden, globally. Further amplifying the burden of NTHi-associated infections is the rapidly expanding spectrum and prevalence of antibiotic resistance, and the lack of an effective vaccination strategy. In 2017, the World Health Organization list of "priority pathogens", highlighted the urgent need for new therapeutic agents against NTHi. Consequently, alternative preventative or...

48. The intricacies of Acinetobacter baumannii: a multifaceted comprehensive review of a multidrug-resistant pathogen and its clinical significance and implications

    Acinetobacter baumannii, a highly adaptive and formidable nosocomial pathogen, has emerged as a symbol of modern medicine's struggle against multidrug resistance (MDR). As a Gram-negative dweller in moist hospital environments, A. baumannii has proven its ability to colonize the most vulnerable-critically ill patients-leaving behind a trail of infections highlighted by high morbidity and mortality and rendering nearly all antibiotics ineffective. This literature review aims to provide an...

49. Re-evaluating what makes a phage unsuitable for therapy

    One of the biggest challenges in phage therapy is selecting the 'right' phage. What constitutes a 'good' phage is unclear, but regulators are converging on exclusion criteria for 'bad' phages. Here, we examine three commonly applied criteria: the lack of virulence/antibiotic resistance, the inability to transduce, and being strictly lytic (virulent). We assess the risk posed, the tools for determining the criteria, and the potential impact of the criteria.

50. Pseudomonas aeruginosa: persistence beyond antibiotic resistance

    The persistence of Pseudomonas aeruginosa in chronic infections extends beyond the issue of antibiotic resistance. A critical, yet unresolved question is why antibiotics fail to eradicate all infecting bacteria, despite P. aeruginosa often being phenotypically susceptible. This highlights the need for a comprehensive understanding of persistence mechanisms, which we consider to be directly rooted in host-pathogen interactions and which are frequently overlooked. We propose that both gene...

51. All-cause mortality and infection-related outcomes of hospital-initiated kangaroo care versus conventional neonatal care for low-birthweight infants: a systematic review and meta-analysis

    BACKGROUND: Kangaroo care has a well-established role in preterm infant stabilisation and in protecting low-birthweight newborns from mortality. Yet kangaroo care is far from fully embedded in conventional inpatient neonatal care practice. The evidence on infection outcomes of hospital-initiated kangaroo care is unclear. We aimed to evaluate the existing evidence to understand the role of hospital-initiated kangaroo care in preventing mortality, sepsis, and invasive infection in low-birthweight...

52. Comparison of Vonoprazan Triple Therapy, Bismuth Quadruple Therapy, and Amoxicillin Therapy for Helicobacter pylori Infection: A Systematic Review

    Helicobacter pylori (H. pylori) infection is a significant global health concern, leading to life-threatening gastric disorders. Despite innovation in standardised treatment protocols, it faces challenges due to rising antibiotic resistance, creating the need for alternative treatments. There is a need to synthesize evidence from recent trials to enhance knowledge in critical care practice. This review synthesizes current trial data to strengthen the understanding of the literature. This...

53. Anti-urease therapy: a targeted approach to mitigating antibiotic resistance in Helicobacter pylori while preserving the gut microflora

    The global rise in antibiotic resistance has posed significant challenges to the effective management of Helicobacter pylori (H. pylori), a gastric pathogen linked to chronic gastritis, peptic ulcers, and gastric cancer. Conventional antibiotic therapies, while effective, face significant challenges, such as increasing antibiotic resistance, high recurrence rates, and adverse effects such as gut microflora dysbiosis. These limitations have driven the exploration of alternative antibiotic-free...

54. The neglected model validation of antimicrobial resistance transmission models - a systematic review

    CONCLUSION: Despite efforts to model antimicrobial resistance and prevention strategies, significant gaps in scope, geographical coverage, drug-pathogen combinations, and viral-bacterial dynamics persist, along with inadequate documentation, hindering model updates and consistent outcomes for policymakers. This review highlights the need for robust modelling practices to enable model refinement as new data becomes available. Particularly, new data for validating modelling outcomes should be a...

55. Role of bestatin as a treatment for periodontitis

    Periodontitis is a chronic inflammatory disease impacting the supporting structures of teeth, with significant global pervasiveness and systemic health implications. Current treatments, such as scaling and root planning (SRP) and adjunctive antibiotics, face challenges including antibiotic resistance, infection recurrence, and incomplete tissue regeneration. Bestatin, a dipeptide aminopeptidase inhibitor, has shown potential as a novel therapeutic agent due to its targeted antimicrobial effects...

56. Discharging Patients With Pending Microbiology Cultures: A Narrative Review of Safety and Best Practices

    Discharging patients with pending microbiology culture results from the hospital has become a common practice aimed at improving hospital throughput and reducing length of stay. One of the main contributors to prolonged hospitalization is the delay in receiving finalized culture results, especially when patients are clinically stable and ready for discharge. Consequently, many hospitals have explored strategies to safely discharge patients before culture results are finalized. While this...

57. Helicobacter pylori Vaccine: Mechanism of Pathogenesis, Immune Evasion and Analysis of Vaccine Types

    Helicobacter pylori (H. pylori) is a gram-negative, spiral-shaped bacterium that colonizes the human gastric mucosa, leading to various gastric diseases. H. pylori infection has become a pressing public health issue that affects more than 50% of the human population worldwide, almost 40 years after its discovery. Traditional treatments, based on the use of bismuth-based triple and quadruple therapies, are effective while facing a series of problems, such as difficulty in patient compliance, the...

58. Evolution of Antiviral Drug Resistance in SARS-CoV-2

    The COVID-19 pandemic has had a significant impact and continues to alarm the entire world due to the rapid emergence of new variants, even after mass vaccinations. There is still an urgent need for new antivirals or strategies to combat the SARS-CoV-2 infections; however, we have success stories with nirmatrelvir. Drug repurposing and drug discovery may lead to a successful SARS-CoV-2 antiviral; however, rapid drug use may cause unexpected mutations and antiviral drug resistance. Conversely,...

59. The Need for the Optimization of HIV Antiretroviral Therapy in Kazakhstan

    The number of people living with HIV in Kazakhstan increased from 11,000 to 35,000 between 2010 and 2021, with emerging antiretroviral therapy (ART) resistance posing a challenge to effective treatment. Unsafe injection practices among people who inject drugs (PWID), the stigma against men who have sex with men, sex work, drug possession, HIV transmission, HIV exposure, and the non-disclosure of HIV status create obstacles to effective prevention and care. Our recent studies with people living...

60. Casein and Casein-Derived Peptides: Antibacterial Activities and Applications in Health and Food Systems

    The growing threat of antimicrobial resistance has intensified the search for alternative strategies to conventional antibiotics and preservatives. Casein-derived antimicrobial peptides (CDAMPs), generated through proteolysis, exhibit potent activity against a broad spectrum of pathogens, including antibiotic-resistant strains, revealing strong potential as natural preservatives and therapeutic agents in food and medical applications. Furthermore, casein can be an ideal source for peptide...

61. Characterization of Antibiotic Resistance in Shewanella Species: An Emerging Pathogen in Clinical and Environmental Settings

    Antibiotic resistance is increasing at an alarming rate worldwide, in large part due to their misuse and improper disposal. Antibiotics administered to treat human and animal diseases, including feed supplements for the treatment or prevention of disease in farm animals, have contributed greatly to the emergence of a multitude of antibiotic-resistant pathogens. Shewanella is one of many bacteria that have developed antibiotic resistance, and in some species, multiple-antibiotic resistance (MAR)....

62. Review of the Presence and Phage-Mediated Transfer of ARGs in Biofilms

    The widespread use of antibiotics has led to the emergence of a large number of drug-resistant bacteria, accelerating the dissemination and spread of antibiotic resistance genes (ARGs) in the environment. Bacterial biofilms, serving as reservoirs of ARGs, pose potential risks to environmental health that should not be ignored. Studies on the presence and transfer of ARGs in biofilms have been conducted both domestically and internationally. This article summarises the research progress on ARGs...

63. Prevalence of Colistin-Resistant Klebsiella pneumoniae Isolates in Turkey over a 20-Year Period: A Systematic Review and Meta-Analysis

    Klebsiella pneumoniae is one of the leading causes of healthcare-associated infections and poses challenges in its treatment owing to its high antibiotic resistance. The development of resistance to colistin, which is used as a last resort, has become a major public health problem worldwide. This study was planned according to the PRISMA guidelines and included studies reporting the prevalence of colistin-resistant K. pneumoniae in Turkey between 2004 and 2024 through a systematic literature...

64. Antimicrobial Resistant Staphylococcus spp., Escherichia coli, and Salmonella spp. in Food Handlers: A Global Review of Persistence, Transmission, and Mitigation Challenges

    Antimicrobial resistance in foodborne pathogens represents a critical global health challenge, with food handlers serving as key contributors in their transmission. This comprehensive review synthesizes evidence on the prevalence, transmission dynamics, and antimicrobial resistance patterns of three major pathogens, Staphylococcus spp., Escherichia coli, and Salmonella spp., among food handlers worldwide. Analysis of studies across diverse geographical regions reveals considerable variation in...

65. Hypervirulent Klebsiella pneumoniae: Insights into Virulence, Antibiotic Resistance, and Fight Strategies Against a Superbug

    Community-acquired infections caused by Klebsiella pneumoniae (K. pneumoniae) have become a significant global health concern, particularly with the emergence of hypervirulent strains (hvKP). These strains are associated with severe infections, such as pyogenic liver abscesses, even in otherwise healthy individuals. Initially reported in Taiwan in the 1980s, hvKP has now spread worldwide. The pathogenicity of hvKP is attributed to an array of virulence factors that enhance its ability to...

66. Recent Developments in Penem Antibiotics: Structural and Therapeutic Perspectives

    This review examines the latest progress of β-lactam antibiotics, focusing on penems. Penems are distinguished by their unique structural characteristics and remarkable antibacterial activity. The structural characteristics of the class that differentiate it from carbapenems or monobactams are addressed. Notable representatives such as sulopenem and faropenem are discussed. Faropenem's stability and efficacy against resistant bacterial strains emphasize the therapeutic potential of penems. The...

67. Insights on the Pathogenesis of Mycobacterium abscessus Infection in Patients with Cystic Fibrosis

    People with CF (pwCF) have a significant risk for pulmonary infections with non-tuberculous mycobacteria (NTM), particularly Mycobacterium abscessus (Mab). Mab is an emerging pathogen, which causes pulmonary infections in patients with chronic lung diseases, particularly CF; Mab pulmonary disease leads to progressive pulmonary dysfunction and increased morbidity and mortality. Despite advances in CF care, including CFTR modulators (CFTRm), Mab continues to pose a therapeutic challenge, with...

68. Medical Potential of Insect Symbionts

    Insect symbionts and their metabolites are complex and diverse and are gradually becoming an important source of new medical materials. Some culturable symbionts from insects produce a variety of active compounds with medical potential. Among them, fatty acids, antibacterial peptides, polyene macrolides, alkaloids, and roseoflavin can inhibit the growth of human pathogenic bacteria and fungi; lipases, yeast killer toxins, reactive oxygen species, pyridines, polyethers, macrotetrolide nactins,...

69. Probiotic, Prebiotic, and Synbiotic Supplementation for the Prevention and Treatment of Acute Otitis Media: A Systematic Review and Meta-Analysis

    CONCLUSIONS: Supplementation with probiotics, prebiotics, or synbiotics is associated with a significant reduction in the incidence of AOM in children, although no significant impact was observed on other key clinical parameters. These interventions may be considered as a complementary strategy to conventional treatments; however, further high-quality, standardized trials are needed to confirm these findings and to define optimal protocols.

70. Combatting Pseudomonas aeruginosa with β-Lactam Antibiotics: A Revived Weapon?

    Pseudomonas aeruginosa is a significant threat to public health as an aggressive, opportunistic pathogen. The use of β-lactam antibiotics such as penicillins, cephalosporins, monobactams, and carbapenems remains a front-line treatment against P. aeruginosa. However, the widespread use of β-lactams has led to the emergence of β-lactam-resistant isolates that significantly increase the economic burden and risk of mortality in patients. With the declining productivity of the antibiotic discovery...

71. Helicobacter pylori Antibiotic Resistance in Russia: A Systematic Review and Meta-Analysis

    Objective: This systematic review and meta-analysis aims to evaluate the temporal changes in Helicobacter pylori antibiotic resistance in Russia based on studies published over the past 15 years. Materials and Methods: We conducted a comprehensive literature search in MEDLINE/PubMed, EMBASE, the Russian Science Citation Index, and Google Scholar, following the PRISMA 2020 guidelines. Our meta-analysis was pre-registered in PROSPERO (CRD 420251025636). The inclusion criteria included original...

72. The Antimicrobial Efficacy of Copper Complexes: A Review

    The alarming increase in antimicrobial resistance has intensified the search for novel therapeutic agents capable of combating resistant microbial strains. Copper complexes have emerged as promising antimicrobial agents due to their intrinsic redox activity, ability to disrupt microbial membranes, and interactions with vital biomolecules such as DNA and proteins. This review critically evaluates the antimicrobial potential of copper complexes reported between 2018 and 2025, emphasizing their...

73. One Health at Risk: Plasmid-Mediated Spread of mcr-1 Across Clinical, Agricultural, and Environmental Ecosystems

    The global dissemination of plasmid-mediated mcr genes, which confer resistance to the last-resort antibiotic colistin, represents a critical public health challenge driven by the interplay of clinical, agricultural, and environmental factors. This review examines the genetic and ecological dynamics of mcr-bearing plasmids, focusing on their role in disseminating colistin resistance across diverse bacterial hosts and ecosystems. Key plasmid families demonstrate distinct evolutionary strategies,...

74. Essential Oils for Biofilm Control: Mechanisms, Synergies, and Translational Challenges in the Era of Antimicrobial Resistance

    Biofilms, structured microbial consortia embedded in self-produced extracellular matrices, pose significant challenges across the medical, industrial, and environmental sectors due to their resistance to antimicrobial therapies and ability to evade the immune system. Their resilience is driven by multifaceted mechanisms, including matrix-mediated drug sequestration, metabolic dormancy, and quorum sensing (QS)-regulated virulence, which collectively sustain persistent infections and contribute to...

75. Clinical Effectiveness of Penicillin-Free Therapies in First-Line and Rescue Treatments for Helicobacter pylori: A Systematic Review

    Background and Aims: Amoxicillin is one of the most effective antibiotics for treating Helicobacter pylori infections and is widely used in first-line treatment regimens. However, patients with penicillin allergies cannot receive penicillin-based therapies, which significantly limits effective eradication options. This allergy often compels clinicians to choose alternative regimens that may be less effective, thereby increasing the risk of treatment failure. Consequently, therapeutic options for...

76. Staphylococcus aureus: A Review of the Pathogenesis and Virulence Mechanisms

    Staphylococcus aureus is a formidable human pathogen responsible for infections ranging from superficial skin lesions to life-threatening systemic diseases. This review synthesizes current knowledge on its pathogenesis, emphasizing colonization dynamics, virulence mechanisms, biofilm formation, and antibiotic resistance. By analyzing studies from PubMed, Scopus, and Web of Science, we highlight the pathogen's adaptability, driven by surface adhesins (e.g., ClfB, SasG), secreted toxins (e.g.,...

77. Antibiotic De-Escalation in the Intensive Care Unit: Rationale and Potential Strategies

    Antibiotic de-escalation (ADE) is important to help optimize antibiotic use and balance the positive and negative effects of antimicrobial therapy. ADE should be performed promptly, and infections should be treated with the shortest course of antimicrobials as clinically feasible to avoid unnecessary use of broad-spectrum antimicrobials. Several tools have been developed to increase efficient ADE, including rapid diagnostic tests (ex. multiplex PCR), MRSA nasal PCR/culture, and biomarkers....

78. Overcoming Pseudomonas aeruginosa in Chronic Suppurative Lung Disease: Prevalence, Treatment Challenges, and the Promise of Bacteriophage Therapy

    Pseudomonas aeruginosa, a multidrug-resistant pathogen, significantly impacts patients with chronic respiratory conditions like cystic fibrosis (CF) and non-CF chronic suppurative lung disease (CSLD), contributing to progressive lung damage and poor clinical outcomes. This bacterium thrives in the airway environments of individuals with impaired mucociliary clearance, leading to persistent infections and increased morbidity and mortality. Despite advancements in management of these conditions,...

79. Leveraging Hospital Information Data for Effective Antibiotic Stewardship

    Clinical informatics has emerged as a valuable approach to enhance antimicrobial stewardship programs in healthcare settings. By integrating information technology with healthcare services, hospitals can systematically collect, store, and utilize medical data to improve antibiotic management. Studies have demonstrated that information technology interventions improve antibiotic prescription appropriateness and patient outcomes. The implementation of effective antimicrobial stewardship employs a...

80. What Do We Know About Staphylococcus aureus and Oxidative Stress? Resistance, Virulence, New Targets, and Therapeutic Alternatives

    Staphylococcus aureus is associated with human infections, being a resistant bacterium involved in serious infections, and its virulence and resistance are linked to oxidative stress. In this study, we review the role of oxidative stress in the pathogenesis of this bacterium and its influence on immune system evasion, antibiotic resistance, and pharmacological targeting. S. aureus infection generates an intense inflammatory response in the host, evidenced by the activation of pro-inflammatory...

81. Solutions to the Dilemma of Antibiotics Use in Livestock and Poultry Farming: Regulation Policy and Alternatives

    While the application of antibiotics in livestock production has undeniably propelled the rapid growth of animal husbandry, the escalating crisis of antimicrobial resistance stemming from antibiotic use poses significant threats to global public health and sustainable agricultural development. To address this critical challenge, multifaceted strategies have been implemented through coordinated policy interventions and scientific innovations. This review systematically examines two pivotal...

82. Snake Venom Compounds: A New Frontier in the Battle Against Antibiotic-Resistant Infections

    The occurrence of antibiotic-resistant bacteria is a serious global health issue, and it emphasizes the need for novel antimicrobial agents. This review explores the potential of snake venom as another alternative strategy against antimicrobial resistance. Snake venoms are complex combinations of bioactive peptides and proteins, including metalloproteases (MPs), serine proteases (SPs), phospholipase A(2) (PLA(2)) enzymes, three-finger toxins (3FTXs), cysteine-rich secretory proteins (CRISPs),...

83. Educational interventions and contextual factors for optimising antibiotic prescription in paediatric uncomplicated acute respiratory tract infections in primary care: scoping review of reviews

    CONCLUSION: We identified a large number of heterogeneous educational interventions. Combining educational interventions plus another type targeting both parents/caregivers and healthcare professionals, and considering their needs and their context may improve antibiotic prescribing in children. Further research is needed on consultation rate, knowledge, attitudes, and satisfaction outcomes and contextual factors, as well as on the cost-effectiveness of the interventions.

84. Natural products as transmission-blocking agents against malaria: a comprehensive review of bioactive compounds and their therapeutic potential

    Malaria eradication is hindered by the persistence of transmission stages of Plasmodium falciparum that enable parasite transfer from humans to mosquitoes. Current therapeutic strategies, such as artemisinin-based combination therapy (ACT) combined with primaquine, are insufficient due to limited efficacy on mature gametocytes and safety concerns in populations with glucose-6-phosphate dehydrogenase deficiency. This highlights the critical need for innovative, safe, and effective...

85. Applying Antimicrobial Strategies in Wound Care Practice: A Review of the Evidence

    Antimicrobial resistance is increasing due to an overreliance on antimicrobials to treat and manage infections. Chronic wounds are particularly vulnerable to infections and harbour complex microbial communities, increasing the risk of secondary infections caused by antimicrobial resistant bacteria. Accurate and early diagnosis of infection ensures appropriate treatment interventions and a reduction in the likelihood that antibiotic use is required. Despite this, the overuse of antibiotic...

86. Antimicrobial resistance with a focus on antibacterial, antifungal, antimalarial, and antiviral drugs resistance, its threat, global priority pathogens, prevention, and control strategies: a review

    Antimicrobial resistance (AMR) poses a significant global health threat by diminishing the effectiveness of once-powerful antimicrobial agents, leading to higher rates of illness and death, along with escalating healthcare costs. While bacterial resistance is a primary concern, resistance is also increasing against antifungal, antiparasitic, and antiviral drugs. Many of the last-resort drugs are becoming less effective due to AMR. Projections indicate that by 2050, AMR could cause up to 10...

87. The interplay between gut microbiota, antibiotics, and immune checkpoint inhibitors in patients with cancer: A narrative review with biological and clinical aspects

    Immune checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1), programmed cell death ligand-1 (PD-L1), and cytotoxic T-lymphocyte antigen 4 (CTLA-4) pathways have revolutionized cancer therapy. However, primary and secondary resistance to ICI pose significant challenges. Recent studies underscore the critical role of gut microbiota (GM) in modulating ICI efficacy by shaping host immune responses and regulating the tumor microenvironment (TME). The composition of the GM has...

88. Antibiotic resistance in Helicobacter pylori: a genetic and physiological perspective

    The identification of Helicobacter pylori (H. pylori) infection as the primary etiology of gastroduodenal diseases represents a significant advancement in the field of gastroenterology. The management of these diseases has undergone a substantial transformation, and antibiotic treatment is now universally applicable. H. pylori has been the subject of numerous investigations to determine the prevalence of antibiotic resistance. However, many of these studies are limited, particularly regarding...

89. A case of hospital-acquired pneumonia associated with Chryseobacterium indologenes infection in a patient with HIV infection and review of the literature

    CONCLUSION: C. indologenes infections remain rare but clinically significant in hospitalized patients with immune dysfunction. The pathogen's multidrug resistance profile complicates treatment, necessitating early identification and targeted antimicrobial therapy. Fluoroquinolones, trimethoprim-sulfamethoxazole, and cefiderocol may serve as effective treatment options, emphasizing the importance of susceptibility-guided management.

90. Prevalence of phenotypic drug resistance profiles and multi-drug-resistant Pseudomonas and Acinetobacter species recovered from clinical specimens in Ethiopia: a systematic review and meta-analysis

    CONCLUSION: The pooled prevalence of Pseudomonas and Acinetobacter species and their antibiotic resistance were alarmingly high in clinical samples in Ethiopia. These findings highlight the crucial need for more antimicrobial surveillance, stronger stewardship programs, and targeted research to combat the growing threat of resistance. Strategic public health policies are required to decrease these pathogens.

91. Antimicrobial efflux and biofilms: an interplay leading to emergent resistance evolution

    The biofilm mode of growth and drug efflux are both important factors that impede the treatment of bacterial infections with antimicrobials. Decades of work have uncovered the mechanisms involved in both efflux and biofilm-mediated antimicrobial tolerance, but links between these phenomena have only recently been discovered. Novel findings show how efflux impacts global cellular physiology and antibiotic tolerance, underpinned by phenotypic heterogeneity. In addition efflux can mediate...

92. Expanding the prevalence of Trichophyton indotineae-associated skin infection by transmission from humans to animals

    Infection with Trichophyton indotineae has been considered an important medical issue in recent times due to the rapid ability of this fungus to develop resistance to different antifungals and its widespread distribution across multiple countries. However, increasing cases of antifungal-resistant infections induce changes in the biological activity of fungi, enabling certain dermatophytes such as T. indotineae to infect both animals and humans. This behaviour has certainly had adverse...

93. Tiny but Mighty: Small RNAs-The Micromanagers of Bacterial Survival, Virulence, and Host-Pathogen Interactions

    Bacterial pathogens have evolved diverse strategies to infect hosts, evade immune responses, and establish successful infections. While the role of transcription factors in bacterial virulence is well documented, emerging evidence highlights the significant contribution of small regulatory RNAs (sRNAs) in bacterial pathogenesis. These sRNAs function as posttranscriptional regulators that fine-tune gene expression, enabling bacteria to adapt rapidly to challenging environments. This review...

94. The Global Burden of Multidrug-Resistant Bacteria

    Background/Objectives: This narrative review provided a broad synthesis of recent epidemiological trends, priority resistance mechanisms, and public health implications of multidrug-resistant (MDR) bacteria. We focused on the most clinically significant MDR pathogens, regional differences in resistance, and the effectiveness of containment strategies. Our goal was to synthesize current knowledge and propose research directions. Methods: Through comprehensive analysis of epidemiological studies,...

95. Dichloroacetate and Salinomycin as Therapeutic Agents in Cancer

    Cancer is the second leading cause of mortality worldwide. Despite the available treatment options, a majority of cancer patients develop drug resistance, indicating the need for alternative approaches. Repurposed drugs, such as antiglycolytic and anti-microbial agents, have gained substantial attention as potential alternative strategies against different disease pathophysiologies, including lung cancer. To that end, multiple studies have suggested that the antiglycolytic dichloroacetate (DCA)...

96. Microbiological and molecular aspects of periodontitis pathogenesis: an infection-induced inflammatory condition

    Periodontitis (PD) is the most common oral infectious disease. The primary etiologic cause of the onset and development of PD is dental plaque, which consists of bacterial biofilm domiciled within a complex extracellular mass. In PD patients, there is a progressive breakdown of the periodontal ligament and the alveolar bone. In more advanced stages, tooth loss occurs. The progression of this chronic inflammatory disease involves interactions among numerous microbial pathogens particularly,...

97. Limitation of the Lytic Effect of Bacteriophages on Salmonella and Other Enteric Bacterial Pathogens and Approaches to Overcome

    Bacteriophages (phages) have emerged as promising agents for combating bacterial pathogens, including nontyphoidal Salmonella enterica (S. enterica), the most common foodborne pathogen worldwide. The emergence of antimicrobial-resistant (AMR) S. enterica poses a severe healthcare issue. Nowadays, many countries worldwide have banned antibiotics for animal feeds or additives, and various strategies have been developed and gained popularity for their potential to address S. enterica infection....

98. Anti-staphylococcal fatty acids: mode of action, bacterial resistance and implications for therapeutic application

    Novel strategies to counter multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus are urgently required. The antimicrobial properties of fatty acids (FAs) have long been recognized and offer significant promise as viable alternatives to, or potentiators of, conventional antibiotics. In this review, we examine the interplay between FAs and S. aureus, specifically detailing the underlying molecular mechanisms responsible for FA-mediated inhibition and the counteracting...

99. C-reactive protein point-of-care testing to guide antibiotic prescribing for respiratory tract infections

    INTRODUCTION: Antimicrobial resistance is strongly correlated with the volume of antibiotics used. Most antibiotics are prescribed in primary care, mostly for respiratory tract infections (RTIs), and are often unneeded.

100. Effect of host microenvironment and bacterial lifestyles on antimicrobial sensitivity and implications for susceptibility testing

     Bacterial infections remain a major global health issue, with antimicrobial resistance (AMR) worsening the crisis. However, treatment failure can occur even when bacteria show antibiotic susceptibility in diagnostic tests. We explore factors such as phenotypic resilience, bacterial lifestyles such as biofilms, and differences between laboratory tests and real infection sites, highlighting the need for improved platforms to better predict treatment outcomes, and reviewing emerging technologies...