The worldwide emergence of antimicrobial resistance and the need for non-conventional alternatives to conventional antibiotics have been increased by multidrug-resistant ESKAPE pathogens, which cause the majority of nosocomial infections and are starting to develop resistance to even the most potent drugs. Engineered bacteriophages are promising precision antimicrobials because of their ability to selectively infect and lyse bacterial hosts, multiply at infection sites, and co-evolve with bacterial populations to overcome resistance. Advances in synthetic biology, such as tail fiber modification, depolymerase and endolysin enhancement, genome editing using the clustered regularly interspaced short palindromic repeats (CRISPR), and computationally designed phage cocktails, have opened new possibilities for therapeutics that were hindered by the limitations of natural phages. These engineering strategies expand host range, enhance biofilm penetration, and target resistance genes. In spite of promising evidence in preclinical models, the use of engineered phages in routine clinical practice remains difficult. Specific key challenges include unclear regulations, lack of good manufacturing practice (GMP)grade production, variable pharmacokinetics and limited clinical trial data. This review critically examines engineering approaches to improve phage activity against ESKAPE pathogens, identifies the scientific and regulatory barriers limiting clinical use, and outlines the key steps needed for wider adoption.

Fungal keratitis (FK) remains a major cause of vision-threatening corneal infection, especially in tropical and subtropical regions, with an expanding epidemiological spectrum driven by environmental, climatic, occupational and host-related factors. Fusarium and Aspergillus were the most common pathogens reported. Greater etiological diversity is reflected by increasing recognition of dematiaceous fungi, uncommon molds, and cryptic species. The literature search was performed by searching bibliographic databases (PubMed and Google Scholar), covering publications from January 2000 to August 2026. Additional relevant studies were identified by screening the reference lists of key publications. This review provides an overview of the current state of FK including changing epidemiology, established diagnostic approaches, emerging technologies, and evolving therapeutic approaches. Conventional microscopy and culture remain central to diagnosis, with molecular methods, sequencing, MALDI-TOF and noninvasive imaging offering advantages in sensitivity, speed and species-level identification. Novel diagnostic methods such as CRISPR-based tests, genome sequencing, artificial intelligence, biosensors and point-of-care diagnostics may provide rapid and accessible precision diagnosis. Therapeutic challenges include poor corneal drug penetration, antifungal resistance and prolonged treatment. Hence, the exploration of new antifungals, nanotechnology-based delivery systems, photoactivated therapies and antimicrobial peptides. These advances support a transition to integrated, rapid and precision-based management of FK collectively.

Antimicrobial resistance (AMR) is a major global health threat that compromises the effectiveness of existing antibiotics and highlights the urgent need for alternative and adjunctive therapeutic strategies. Probiotics have emerged as potential adjunctive strategies because of their ability to modulate host-microbe interactions and influence microbial ecology without promoting resistance. This review examines the current evidence on the potential role of probiotics in combating multidrug-resistant organisms, based on findings from in vitro studies, animal models, and clinical investigations. The review is based on a narrative literature search of the PubMed database, covering studies published between 2020 and 2025, with earlier landmark studies. The mechanisms discussed include competitive exclusion of pathogens, the production of antimicrobial compounds, the enhancement of intestinal barrier function, and the modulation of host immune responses. In addition, probiotics are evaluated for their capacity to interfere with quorum sensing and inhibit biofilm formation, thereby reducing pathogen virulence and colonization. The review also addresses key limitations, including strain-specific variability, safety concerns in vulnerable populations, and the lack of standardized clinical protocols. Current evidence suggests that probiotics may represent a useful adjunct to existing AMR management strategies. However, their broader clinical application requires larger research to establish their efficacy and safety.

The growing resistance to antibiotics by Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) is a global health threat. Traditional antibiotics act on the viability of bacteria, whereas new ones are now increasingly targeting virulence factors. Phenol-soluble modulins (PSMs) are essential virulence factors that play important roles in inflammation, neutrophil lysis, cytotoxicity and biofilm formation. PubMed, Scopus, Web of Science and Google Scholar were used for literature search of articles published between 2010 and 2026. Green-synthesized metal nanoparticles (NPs) have been found to be capable of altering these mechanisms by inducing reactive oxygen species (ROS) production, membrane damage, and by interfering with the quorum-sensing mechanism of the bacteria, along with inhibiting the Agr system. Optimization of NP-based interventions can be supported by multi-omics approaches such as genomics, transcriptomics, proteomics and metabolomics. Other potential methods of targeted PSM pathway and Agr pathway suppression are also available, such as CRISPR-Cas9 and dCas9, but there are delivery difficulties. The potential use of combining nanotechnology, gene editing, multi-omics, artificial intelligence, and synthetic biology could allow for development of more advanced anti-virulence strategies against S. aureus infections targeted at PSM.

Spinal neurocysticercosis (NCC) is an uncommon manifestation of NCC involving the spinal cord, meninges, nerve roots, and subarachnoid spaces. Although less common than intracranial disease, spinal involvement can cause substantial neurological morbidity because even small lesions within the confined spinal canal may produce progressive myelopathy. Disease may result from hematogenous dissemination or cerebrospinal fluid (CSF) spread of Taenia solium larvae and may present as intramedullary, intradural extramedullary, subarachnoid, or, rarely, extradural lesions. Clinical manifestations are diverse and include paraparesis, quadriparesis, cauda equina syndrome, and chronic meningitis. Magnetic resonance imaging is the diagnostic modality of choice, providing detailed assessment of lesion location, evolutionary stage, inflammatory activity, and associated complications. CSF analysis and immunological or molecular tests provide supportive evidence, while histopathological examination confirms the diagnosis when tissue is available. Treatment is individualized and may include antiparasitic agents, corticosteroids, and surgery when indicated. Although outcomes are generally favorable with early diagnosis and appropriate treatment, delayed treatment, extensive arachnoiditis, diffuse leptomeningeal disease, and established spinal cord damage may result in permanent neurological deficits. Further prospective studies are needed to refine diagnostic strategies and optimize management. PubMed database was searched from inception to 13 July 2026, for spinal neurocysticercosis and spinal cysticercosis.

Brucella mastitis represents a rare infectious disease that is frequently misdiagnosed as metastatic breast carcinoma, particularly when older women present with systemic manifestations. Here, we report a 60-year-old woman presenting with a neck pain and left upper extremity numbness. Initial contrast-enhanced magnetic resonance imaging (CEMR) and 18[F]-FDG PET-CT highly suggested breast malignancy with osseous metastasis, while contrast-enhanced ultrasound (CEUS) provided critical microvascular perfusion insights favoring an inflammatory process. The diagnosis was ultimately confirmed via blood culture and pathological examination. The patient was successfully treated with targeted antimicrobial treatment. This case offers important insights into the multimodal imaging differentiation of atypical breast lesions and emphasizes the diagnostic challenges of Brucella mastitis accompanied by systemic osteoarticular involvement.