The results of an outbreak investigation of pneumonic plague conducted in the plague-endemic district of Fenoarivobe, Madagascar, revealed a familial cluster of plague. Transmission was aided by intrahousehold contact or gatherings and was amplified by delayed plague treatment, highlighting the need for early diagnosis and rapid initiation of appropriate therapy.

A renal transplant recipient in India receiving trimethoprim/sulfamethoxazole prophylaxis experienced fever, hemoptysis, and neurologic deficits. The diagnosis was pulmonary aspergillosis and disseminated nocardiosis caused by trimethoprim/sulfamethoxazole-resistant Nocardia. Antimicrobial drug therapy led to complete clinical and radiological resolution after 6 months. This case highlights a resistant breakthrough Nocardia pathogen in a transplant recipient.

Whole-genome sequencing strengthens tuberculosis surveillance, but incomplete lineage schemes can misclassify isolates. We developed Pathotypr, an alignment-free tool for assemblies and reads, using 2,145 markers derived from 26,813 genomes. Across 88,071 samples, Pathotypr improved concordance, expanded uncommon lineage coverage, and detected resistance markers, supporting molecular epidemiology and public health surveillance.

We report on an immunocompromised patient in southeast France who sought care for fever, knee arthritis, and skin erythema. Blood and joint samples were positive for Spiroplasma turonicum, an intracellular gram-negative bacterium generally found in plants, insects, and ticks. Clinicians should be aware of possible S. turonicum infection in immunocompromised patients.

We evaluated the transmission dynamics of dengue virus (DENV) during 2010-2025 in Ceará State, Brazil. Ceará has been a dengue hyperendemic region, where all 4 DENV serotypes co-circulate, predominantly DENV-1 and DENV-2, and where DENV-3 was recently reintroduced. Our findings provide an epidemiologic baseline for postlicensure dengue vaccine evaluation.

We analyzed 919 Streptococcus pyogenes isolates from laboratory-confirmed streptococcal toxic shock syndrome cases in Japan during 2023-2024. Post-COVID-19 resurgence was driven by expansion of M1UK (49.8%) and emerging M113SNPs (37.4%) lineages, replacing ancestral M1global. M113SNPs were associated with younger patient age and higher death rates in unadjusted analyses.

We describe a fatal Rickettsia parkeri rickettsiosis case in a 3-year-old boy in Georgia, USA, receiving chemotherapy for B-cell acute lymphoblastic leukemia, hospitalized with febrile neutropenia. Plasma microbial cell-free DNA sequencing confirmed the diagnosis. This report highlights the need to maintain suspicion for tickborne diseases in immunocompromised hosts in some settings.

In 2025, a respiratory disease outbreak occurred among camels in Kazakhstan. We detected Middle East respiratory syndrome coronavirus by using quantitative reverse transcription PCR in 38 symptomatic camels, demonstrating active circulation in Central Asia. Our findings highlight the need for enhanced surveillance to assess zoonotic transmission risk.

We report 2 cases of asymptomatic Dirofilaria microfilaremia in humans in Sri Lanka, detected during night blood surveillance for lymphatic filariasis in 2025. Partial sequence of microfilarial cytochrome c oxidase 1 gene revealed that both infections were caused by the novel species D. asiatica, originally described in Hong Kong as Candidatus D. honkongensis.

Filarial nematodes cause significant illness worldwide, including lymphatic and subcutaneous filariases in tropical regions. Dirofilaria asiatica is a recently described canine filarioid increasingly implicated in zoonotic human infections. Here, we report a patent infection in a child in Sri Lanka who had persistent microfilaraemia after 2 rounds of diethylcarbamazine treatment.

Highly pathogenic avian influenza A(H5Nx) viruses, particularly clade 2.3.4.4b, pose substantial global health risks. We combined and piloted 2 duplex reverse transcription digital PCRs to discriminate between avian and seasonal influenza viruses in wastewater. This approach enabled rapid, strain-specific detection to reduce ambiguity in environmental surveillance for influenza viruses.

Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging cause of invasive infection, but clinical relevance of a 5-biomarker genotypic definition remains unclear. We analyzed 207 episodes of K. pneumoniae bloodstream infection at a tertiary hospital in Japan during 2022-2024. We defined hvKp by PCR detection of all 5 biomarkers: rmpA, rmpA2, iucA, iroB, and peg-344. Overall, hvKp accounted for 14% (28/207) of episodes. Abscess complications occurred in 61% (17/28) of hvKp episodes and 13% (23/179) of classical K. pneumoniae episodes. hvKp case-patients had longer median hospitalization (28 vs. 14 days) and duration of antimicrobial drug treatment (43 vs. 14 days) than those with classical K. pneumoniae. Most (9/10) sequence type 23 hvKp episodes involved abscesses. Short-read whole-genome sequencing detected CTX-M-type extended-spectrum β-lactamase genes in 11% (3/28) of hvKp isolates, representing 1.4% (3/207) of all K. pneumoniae episodes. The 5-biomarker definition delineated a clinically distinct subgroup, demonstrating its value for genomic surveillance of emerging hvKp.

Cross-reactive SARS-CoV-2-specific antibodies could compromise the specificity of MERS-CoV serology, potentially leading to misclassification of infection history. SARS-CoV-2 exposure induced MERS-CoV antibodies primarily targeting the conserved S2 domain, with occasional neutralizing capacity. Combining MERS-CoV S1 binding with neutralization, however, limited the influence of SARS-CoV-2-induced cross-reactivity on MERS-CoV serology.

Metastatic infection after Candidozyma auris candidemia remains poorly characterized. We retrospectively studied patients with C. auris candidemia at a tertiary hospital in Spain during 2016-2024. Of 108 patients, 24 (22.2%) experienced metastatic infections; endocarditis was most frequent (7.4%), followed by osteoarticular infection, meningitis, and hepatosplenic infection (3.7% each). In multivariable Fine-Gray regression, a cardiac device or prosthetic valve was independently associated with metastatic infection (subdistribution hazard ratio [HR] 2.89 [95% CI 1.21-6.91]), although that association was attenuated in a sensitivity analysis restricted to echocardiographed patients. Persistent candidemia showed a higher, nonsignificant risk for metastatic infection in the day-5 landmark analysis (subdistribution HR 2.67 [95% CI 0.86-8.32]). Metastatic infection was associated with increased deaths in time-dependent analyses at 60 days (adjusted HR 2.21 [95% CI 1.04-4.67]) and 90 days (adjusted HR 2.26 [95% CI 1.09-4.67]). Our findings support echocardiography in patients with intracardiac devices.

Accurate knowledge of microbial etiology is essential for optimizing spinal fusion surgical site infection (SSI) management, yet contemporary national data in the United States, particularly prevalence and factors associated with gram-negative infections, remain poorly understood. We conducted a cross-sectional analysis of US data reported to the Centers for Disease Control and Prevention National Healthcare Safety Network (2021-2022) to characterize the microbiology of spinal fusion SSI and identify factors associated with gram-negative infection. Among 7,187 cases, gram-negative organisms caused 31.5% (n = 2,265) of SSIs. Older age, female sex, higher body mass index, longer operative times, higher American Society of Anesthesiologists class, lumbar involvement, inpatient surgery, and emergent and trauma surgeries were independently associated with gram-negative infections relative to monomicrobial Staphylococcus aureus infections. Our findings might inform future studies focusing on high-risk cohorts as targets for expanded gram-negative prophylactic regimens. Clinicians can use risk profiles to guide empiric gram-negative antibiotic coverage in treating SSIs.