SUMMARYStreptococcus suis is a swine pathogen causing significant economic losses and an important zoonotic agent in humans. Southeast Asia is a high-incidence region, where infection is strongly linked to consumption of raw or undercooked pork and occupational exposure to pigs or pork products. Thailand and Vietnam report the highest case numbers, with additional cases in Indonesia (Bali), Malaysia, Singapore, Lao PDR, and Cambodia. Serotype 2 predominates in both humans and pigs, followed by serotype 14, while other serotypes (1, 4, 5, 7, 9, 16, 24, and 31) are also reported in humans. In pigs, a broader serotype range is observed, including 1 or 14, 2, 4, 5, 6, 7, 8, 9, 15, 16, 18, 21, 29, 31, and nontypeable strains. Human infections involve multiple clonal complexes (CC1, CC16, CC25, CC28, CC94, CC104, CC233, CC221/234, and CC1688), several overlapping with porcine lineages. The region is also challenged by increasing antimicrobial resistance, with rising non-susceptibility to macrolides and tetracyclines and occasional reduced susceptibility to penicillin. Diagnostic limitations due to misidentification, limited molecular tools, and reliance on conventional methods further complicate surveillance. The economic burden is substantial, driven by swine losses, treatment costs, outbreaks, and severe human disease. Vaccination remains suboptimal due to limited protection against genetically and antigenically diverse strains across serotypes and CCs. An urgent One Health approach integrating animal health, food safety, and human health is needed to monitor S. suis dynamics. Control measures should target farms, slaughterhouses, and retail markets while promoting community-accepted behavioral changes to reduce transmission risk.

SUMMARYMycoplasma pneumoniae pneumonia (MPP) is an acute respiratory infection caused by Mycoplasma pneumoniae (MP) and constitutes the primary cause of community-acquired pneumonia (CAP) among children aged 5 years and older in China. The clinical manifestations of MP-associated respiratory disease in children are diverse, ranging from mild upper respiratory symptoms to life-threatening pneumonia. Notably, during the implementation of nonpharmaceutical interventions (NPIs) aimed at curbing SARS-CoV-2 transmission, there was a significant decline in MP infection rates. However, a pronounced global resurgence of MP infections was documented in 2023-2024. The increasing global prevalence of macrolide resistance, particularly in China, coupled with limited alternative antibiotic options for children, increasing rates of coinfections, and the absence of a preventive vaccine, collectively exacerbate treatment challenges and increase the disease burden. Furthermore, the insufficient availability of MP nucleic acid testing and antimicrobial resistance surveillance in primary healthcare settings, coupled with the absence of a comprehensive epidemiological monitoring network, results in a vicious public health cycle. Recent advances and emerging genomic data have provided new insights into its pathogenesis and clinical management. Therefore, in this narrative review, we aim to (i) synthesize the current understanding of the etiological characteristics of MP and the present status of MPP diagnosis and treatment; (ii) analyze recent advances and drivers behind the global resurgence of MP infections; and (iii) propose integrated prevention and control strategies to increase the recognition of MPP and prevent unanticipated outbreaks.

SUMMARYLoop-mediated isothermal amplification (LAMP) is a type of isothermal nucleic acid amplification test (NAAT). Compared to more traditional NAATs, like polymerase chain reaction (PCR), LAMP is run at one consistent temperature, utilizes four to six primers, and uses Bst polymerase. Some advantages that are provided by these differences are that LAMP has lower equipment requirements, resiliency to common PCR inhibitors, and a rapid time to result. Unfortunately, some disadvantages are also present due to these differences, such as more challenging primer design, reduced multiplexing capability, and difficulty with quantitation. Due to its unique characteristics, LAMP has proven to be an attractive option for molecular diagnostics in resource-limited, point-of-care, and near-patient testing settings. However, its adoption in clinical settings remains limited compared to its widespread use in research. In this review, we cover various detection methods within LAMP, recent advancements including extraction, multiplexing, and quantification, as well as key clinical applications of LAMP from a syndromic perspective. We also explore the commercial potential of LAMP and how it can be leveraged in resource-constrained settings and clinical laboratories, especially where early, affordable, and rapid diagnosis is essential.

SUMMARYDNA sequencing has revolutionized microbial surveillance in cystic fibrosis (CF), transforming pathogen identification from culture-dependent to total microbial community identification using molecular-based approaches. Techniques such as 16S rRNA gene sequencing have uncovered the complexity of the CF airway microbiome, while shotgun metagenomics, metatranscriptomics, and viromics now provide strain-level, functional, and viral insights beyond bacterial identification. Despite these advances, key technical and logistical challenges remain, including the processing of high-viscosity sputum samples, overwhelming host DNA contamination, managing large data sets, and the integration of complex bioinformatic outputs into clinical workflows. Emerging innovations such as host DNA depletion protocols, targeted enrichment panels, and adaptive sampling on Oxford Nanopore platforms are helping to overcome these barriers, improving microbial recovery and sequencing efficiency. As cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies are changing the lives of people with cystic fibrosis (pwCF), sequencing offers an unprecedented opportunity to track potential microbial adaptation in response. This review investigates current advances, limitations, and translational opportunities in DNA sequencing for CF airway microbiome surveillance, highlighting how these technologies can help reshape research and clinical microbiology in the post-modulator era.

SUMMARYIntra-amniotic infection is the main cause of spontaneous preterm birth and adverse maternal-fetal outcomes; therefore, rapid, robust, and accurate diagnosis remains a clinical priority. Conventional microbiological techniques, especially culture-based methods, are limited by long turnaround times and the inability to detect fastidious or unculturable organisms. This review summarizes the diagnosis, nomenclature, clinical significance, management, and laboratory approaches for diagnosing intra-amniotic infection. Targeted nucleic acid amplification methods, including species-specific polymerase chain reaction and broad-range 16S rRNA gene sequencing, have improved the detection of bacterial DNA and enabled the identification of organisms that evade routine culture in intra-amniotic infection. More recently, whole-genome sequencing and metagenomic next-generation sequencing have provided culture-independent strategies for comprehensive pathogen profiling, allowing simultaneous detection of bacteria, viruses, and fungi, as well as characterization of antimicrobial resistance determinants and virulence-associated genes. However, challenges remain, particularly in low-biomass samples such as amniotic fluid, where contamination, host DNA background, and data interpretation can compromise specificity. This review critically evaluates the advantages and limitations of each molecular modality and discusses pre-analytical, analytical, and bioinformatic considerations essential for reliable implementation. Integration of molecular diagnostics into clinical workflows holds promise for improving etiological diagnosis and guiding targeted therapy in intra-amniotic infection, thereby improving maternal and fetal outcomes.

SUMMARYLeptospirosis, a widespread zoonotic disease caused by pathogenic Leptospira species, remains a major public health challenge, particularly in tropical and subtropical regions. Despite advances in understanding Leptospira biology and pathogenesis, effective disease control continues to be limited by the lack of rapid, early diagnostics, and broadly protective vaccines. This review comprehensively examines recent progress in deciphering Leptospira-host interactions, with emphasis on key virulence factors, immune-evasion mechanisms, and host immune responses that influence disease outcomes. Particular focus is placed on the molecular and cellular basis of adhesion, invasion, immune modulation, and persistent colonization. We further discuss the limitations of current vaccines and diagnostic approaches, and highlight how emerging technologies, including pan-genomics, proteomics, reverse vaccinology, immunoinformatics, and omics-based antigen discovery, are facilitating the development of next-generation vaccines and diagnostics. Finally, we outline major translational challenges and future perspectives for improving clinical management, surveillance, and prevention of leptospirosis. The concepts discussed in this review may also provide broader insights into vaccine and diagnostic development for other zoonotic bacterial infections.

SUMMARYThe year 2026 marks the 25th anniversary of the discovery of human metapneumovirus (HMPV), which belongs to the metapneumovirus genus within the Pneumoviridae family. The respiratory syncytial virus (RSV), discovered in 1956, is a close relative of HMPV belonging to the same family but to a different genus. In this article, we review key past findings related to HMPV infection, highlighting the differences with RSV. In addition, we specifically discuss current research areas pertaining to changing epidemiology, clinical burden, host response, as well as therapeutic and prophylactic modalities now in clinical trials. Additional research on HMPV is needed to contain this important respiratory virus.

SUMMARYRickettsial diseases, encompassing scrub typhus, spotted fever group rickettsioses, and typhus group rickettsioses, represent a significant and escalating public health threat worldwide, particularly in the Asia-Pacific and sub-Saharan African regions. Despite their high morbidity and potential for fatal outcomes if left untreated, these infections remain notoriously underdiagnosed due to their nonspecific clinical presentation, which frequently overlaps with other acute undifferentiated febrile illnesses (AUFIs) such as dengue, malaria, and leptospirosis. This review evaluates the evolving diagnostic landscape, highlighting the severe limitations of conventional methods: the Weil-Felix test lacks necessary specificity, while the gold standard indirect immunofluorescence assay (IFA) is primarily retrospective due to delayed seroconversion. Molecular diagnostics, particularly multiplex polymerase chain reaction (mPCR), have emerged as a critical advancement, enabling early, species-specific identification during the acute phase of infection when doxycycline therapy is most effective. We further explore the paradigm shift toward syndromic molecular panels, such as the TaqMan Array Card (TAC), which facilitate simultaneous screening for multiple AUFI pathogens. Emerging platforms, including digital PCR (dPCR) for absolute quantification and CRISPR-Cas-based point-of-care (POC) systems (SHERLOCK and DETECTR), offer promising solutions for low-resource settings. Finally, this review underscores the necessity of integrating molecular surveillance within a One Health framework and utilizing artificial intelligence (AI) to address technical and implementation barriers. Overcoming these challenges is essential for transforming rickettsial diagnosis from a reactive to a proactive strategy, ultimately reducing the global burden of these neglected zoonoses.

SUMMARYThe messenger RNA (mRNA)-lipid nanoparticle (LNP) vaccine platform is the newest tool in the vaccination arsenal for combating infectious diseases, rare genetic diseases, and cancer. Since 2020, major advances in preclinical and clinical studies have demonstrated the efficacy of mRNA-LNP vaccines against viral pathogens and in cancer. However, studies investigating the efficacy of mRNA-LNP vaccines against bacterial pathogens remain sparse due to substantial bacterial vaccine-specific challenges. Here, we highlight key challenges impeding the development of mRNA-LNP vaccines against human bacterial pathogens, the advantages that can be gained by utilizing the mRNA-LNP platform for bacterial vaccines, and progress toward the development of mRNA-LNP vaccines against bacterial infections.

SUMMARYColorectal cancer (CRC) is a significant global health concern that is growing in prevalence, especially in younger populations. The gut microbiome is an increasingly recognized factor in the development and progression of numerous diseases, including CRC. This review explores the current research on the causal relationship between the microbiome and CRC, including the strengths and limitations of the current models for studying this complex interaction. We then delve into key microbial metabolites and their effects on host signaling pathways in the context of CRC and highlight specific bacterial species with direct links to CRC development and progression. Existing microbiota-targeted therapies such as pre- and pro-biotics and fecal microbiota transplantation are described, as well as innovative microbiome-focused strategies that are currently in development, like quorum quenching. Finally, we address the major challenges in the field, such as conflicting research findings and the need for a systems-level, multi-omic approach to describe the intertwined and bidirectional host-microbe interactions.

SUMMARYThe skin harbors a diverse fungal community that contributes to both epidermal homeostasis and inflammatory disease. Historically, studies of cutaneous fungi focused primarily on opportunistic infections in immunocompromised hosts. Advances in sequencing technologies and metagenomic analyses have revealed that commensal yeasts of the skin microbiome likely influence host physiology and cutaneous disease severity. In this review, we summarize the current knowledge of host-fungal interactions at the skin epithelium, with particular emphasis on the yeast genera Malassezia and Candida. We discuss how fungal colonization shapes epidermal biology through direct interactions with keratinocytes and immune cells, highlighting fungal virulence factors such as secreted proteases and candidalysin, as well as host-sensing pathways. We further examine how these interactions contribute to inflammatory skin diseases, particularly atopic dermatitis and psoriasis, and how fungi participate in polymicrobial networks with bacteria and viruses to alter susceptibility to infection. Finally, we discuss how emerging therapeutic strategies change the fungal composition on skin. These advances suggest the importance of fungi as active regulators of skin immunity and emphasize key knowledge gaps that need to be addressed in future studies to better understand how they contribute to cutaneous diseases.

SUMMARYIn recent years, coxsackievirus A6 (CVA6) has become a predominant cause of hand, foot, and mouth disease (HFMD) worldwide, surpassing enterovirus A71 (EV-A71) and CVA16. The rise of CVA6 is of particular public health concern due to its association with atypical and severe clinical presentations, including extensive vesiculobullous eruptions and neurological complications. These diverse and often non-classical manifestations, which also occur in adults, complicate clinical diagnosis and highlight the need for enhanced molecular surveillance. Furthermore, the potential impact of enteroviral infection during pregnancy and on neonatal outcomes remains an important clinical consideration. While both structural and non-structural proteins of CVA6 are known to contribute to viral virulence, the underlying pathogenic mechanisms are not fully understood. Continuous evolution of CVA6 through genetic variation and frequent recombination has led to the emergence of distinct lineages and recombinants, posing substantial challenges to the development of effective antivirals and vaccines. To address these gaps, this review systematically examines the global epidemiology, pathogenic mechanisms, evolutionary dynamics, current diagnostic tools, and antiviral strategies for CVA6. By integrating these perspectives, this work aims to inform public health preparedness and guide future research toward mitigating outbreaks driven by emerging recombinants and novel enterovirus serotypes.

SUMMARYUrinary tract infections (UTIs) are among the most common bacterial infections worldwide, with catheter-associated UTIs (CAUTIs) representing a major subset in healthcare settings. CAUTIs significantly increase patient morbidity, mortality, hospital stays, and healthcare costs, while driving antibiotic overuse and antimicrobial resistance (AMR). Systemic antibiotics often fail due to poor biofilm penetration, localized infection sites, and rising multidrug resistance, highlighting the urgent need for alternative, targeted therapies. This review discusses the role of intravesical therapies in both the treatment and prevention of CAUTIs, with a primary emphasis on therapeutic applications. The bladder is an accessible target for local treatment, as catheters can be repurposed for drug delivery. These devices are frequently colonized by biofilm-forming bacteria that contribute to persistent infection and treatment failure. This review explores intravesical therapy, the direct instillation of antimicrobial agents into the bladder, as a promising strategy to improve CAUTI management and mitigate AMR. We examine CAUTI pathogenesis, biofilm development, and current clinical approaches, including antimicrobial stewardship, catheter management, and coating technologies. Evidence for intravesical antibiotics such as gentamicin, amikacin, colistin, fosfomycin, and trimethoprim is reviewed alongside limited data from clinical trials, and applications in other urological disorders. Non-antibiotic alternatives, including sterile saline, antiseptic solutions, bacteriophages, antimicrobial peptides, natural bioactives, probiotics, and silver nanoparticles, are also discussed, particularly for their potential synergistic use with antibiotics to reduce resistance emergence. Despite encouraging results, intravesical therapy faces challenges such as limited clinical data, lack of standardized protocols, and delivery barriers. This review summarizes current evidence, identifies research gaps, and proposes directions to advance this underused strategy against CAUTIs amid escalating antibiotic resistance.

SUMMARYPlasmodium vivax remains a major barrier to global malaria elimination due to dormant liver-stage hypnozoites that drive relapse and sustain transmission even in low-endemic settings. India accounts for nearly half of the global P. vivax burden, placing it at the center of elimination efforts. This review synthesizes current evidence on the epidemiology, biology, and control of P. vivax in India. Despite progress, early gametocytogenesis, hypnozoites, low parasitemia, and immune evasion complicate diagnosis and treatment. Recent single-cell and multi-omics studies are elucidating vir gene regulation, epigenetic control of hypnozoite dormancy, and quiescent liver-stage biology. Diagnostic gaps persist because microscopy and rapid diagnostic tests poorly detect asymptomatic infections, and molecular surveillance cannot map relapse without hypnozoite biomarkers. Standard radical cure with chloroquine and 14-day primaquine is limited by poor adherence and restricted glucose-6-phosphate dehydrogenase testing, while single-dose tafenoquine awaits wider implementation. Urban malaria, largely driven by P. vivax and Anopheles stephensi, is increasing as a consequence of rapid urbanization and vector adaptation. National initiatives such as the Integrated Health Information Platform, Tribal Malaria Action Plans, and Urban Malaria Schemes are critical but face constraints in surveillance integration, private sector reporting, and cross-border coordination. We highlight emerging experimental liver models, single-cell technologies, and systems biology frameworks as essential tools for addressing key knowledge gaps in relapse biology. Sustained investment and interdisciplinary collaboration will be required for India to lead P. vivax elimination and translate national progress into global impact.

SUMMARYPreterm infants face a unique trajectory of gut microbiome assembly, shaped by the convergence of physiological immaturity, necessary clinical interventions, and the neonatal intensive care unit environment. This dysbiotic ecosystem-characterized by low diversity, depletion of beneficial commensals such as Bifidobacterium, and expansion of pathobionts, including Enterobacteriaceae-is increasingly recognized as a central mediator of neonatal morbidity. This review synthesizes current evidence on preterm microbiome development, its role in necrotizing enterocolitis through mechanisms involving Toll-like receptor 4 signaling, bile acid dysmetabolism, and immune dysregulation, and its systemic impact via gut-organ axes linking the intestine to the brain, lung, eye, and systemic circulation. We critically evaluate microbiome-targeted interventions across the translational spectrum, from foundational practices such as human milk feeding and antibiotic stewardship to active modulation with probiotics and prebiotics, and emerging precision strategies, including postbiotics, phage therapy, and fecal microbiota transplantation. Methodological advances in multi-omics, machine learning, and digital twin modeling are paving the way for personalized, predictive microbiome-mediated care. We also address the hidden burden of antimicrobial resistance in the preterm gut and the challenges of translating mechanistic insights into clinical practice. Looking forward, embracing the complexity of the preterm microbiome as a dynamic, multi-kingdom ecosystem is essential for developing holistic interventions that improve both short-term survival and long-term neurodevelopmental, respiratory, and metabolic outcomes.