The approach to multidrug-resistant (MDR) Gram-negative bacilli (GNB) infections has changed following the introduction of avibactam-based β-lactam/β-lactamase inhibitor combinations. Ceftazidime/avibactam has become a cornerstone for the treatment of infections caused by KPC-producing Enterobacterales, whereas the recent availability of aztreonam/avibactam has provided the first targeted option against metallo-β-lactamase (MBL)-producing Enterobacterales. At the same time, the emergence of KPC variants, the increasing dissemination of MBLs and the growing complexity of resistance mechanisms have made both empirical and targeted therapeutic decisions increasingly challenging. This narrative review summarizes the current evidence regarding the microbiological activity, clinical efficacy and optimal place in therapy of avibactam-based combinations. Ceftazidime/avibactam is a cornerstore for the treatment of KPC infections, and significantly modified the outcome of patients with KPC infections during the last decade. Robust observational studies demonstrated its clinical efficacy and safety. It may also represent a carbapenem-sparing option for treating infections due to difficult-to-treat ESBL- and OXA-48-producing Enterobacterales. Moreover, its activity against MDR Pseudomonas aeruginosa makes it an attractive option for empirical therapy in patients with risk factors for this non-fermenting GNB. Aztreonam/avibactam represents the first-line option for the treatment of MBL-producing Enterobacterales and plays a pivotal role in the current era of increasing dissemination of multiple carbapenemases. Their optimal clinical positioning should rely on optimal use in empirical therapy in patients with rectal colonization with carbapenem-resistant Enterobacterales who develop sepsis or septic shock, antimicrobial stewardship principles and integration of local epidemiology, microbiological data and patient characteristics to maximize efficacy while preserving their long-term activity.

Helicobacter cinaedi is an emerging Gram-negative pathogen, possibly involved in the pathogenesis of atherosclerosis and increasingly recognized as a cause of bacteraemia, cellulitis and vascular infections, particularly in immunocompromised and elderly patients. Infection of vascular grafts by H. cinaedi remains exceedingly rare. We report a case of H. cinaedi infection involving an aortic aneurysm and an aorto-bi-iliac endoprosthesis in an immunocompetent patient, highlighting the diagnostic challenges posed by culture-negative infections and the crucial role of Next-Generation Sequencing (NGS) in pathogen identification and therapeutic management.

Dengue Fever (DF), caused by the Dengue virus (DENV), represents a major and expanding global public health challenge. Vaccination is an important public health tool that could prevent Dengue infection and reduce symptoms, including severe Dengue. Several dengue vaccines have been studied and implemented in selected countries; however, evidence on their efficacy/effectiveness, safety, and optimal use varies across populations and settings, highlighting the need for a comprehensive evaluation.

Tick-borne encephalitis (TBE) is an emerging viral infection in Europe and Asia. Climate and environmental changes are expanding the distribution and activity of Ixodes ticks, increasing human exposure. Most infections are asymptomatic, but symptomatic cases may present with a biphasic illness that can progress to meningitis or encephalitis, sometimes leading to long-term neurological sequelae, particularly in the elderly population. Currently, treatment is limited to supportive care, as no specific antiviral therapy is available. Effective vaccines exist and represent the main preventive strategy, although coverage remains variable. This paper provides an overview of epidemiology, clinical features, and prevention of TBE.

Campylobacter jejuni is a common cause of bacterial gastroenteritis, while cardiac involvement is a rare extraintestinal complication. We report the case of a 21-year-old immunocompetent man who developed acute perimyocarditis three days after microbiologically confirmed C. jejuni enteritis. He presented with pleuritic chest pain, elevated inflammatory markers, and increased high-sensitivity troponin I levels. Echocardiography showed preserved ventricular function, whereas cardiac magnetic resonance imaging (CMR) demonstrated myocardial edema and subepicardial-to-mid-myocardial late gadolinium enhancement, fulfilling the Revised Lake Louise Criteria for acute myocarditis. The patient had an uncomplicated clinical course and was discharged in stable condition. This case highlights the importance of considering perimyocarditis in young patients presenting with chest pain following recent gastroenteritis and underscores the diagnostic value of CMR.

Knowledge regarding parasites and the diseases they cause remains limited in the pre-microscopic era. Historical medical records concerning cutaneous parasitic infections often lack precision, leaving our understanding of these conditions in earlier centuries largely speculative. While the history of intestinal parasites is well-documented back to antiquity, literature on cutaneous parasites and filariasis primarily dates only to the late 18th century. However, Cerrahiyetü'l Haniyye - the first illustrated surgical textbook written in 15th century Anatolia - presents these conditions in a manner strikingly consistent with modern clinical understanding. This seminal work offers a definitive, early account of cutaneous parasites, accompanied by detailed clinical descriptions that require no interpretation. Furthermore, the unique arrangement of miniature illustrations depicting surgical procedures performed to treat skin parasites makes an extremely important contribution to the known history of skin parasites.

Antimicrobial resistance (AMR) represents a major global public health concern, rendering available antimicrobials ineffective and leading to infections that are difficult to treat. Artificial intelligence (AI) has been increasingly applied across the AMR continuum, including resistance prediction, rapid diagnostics, new antimicrobial discovery, drug repurposing, antimicrobial surveillance, and clinical decision support. In this review, we aim to highlight recent developments in the use of artificial intelligence (AI) to address antimicrobial resistance (AMR). In addition, we review computational methods that help interpret genomic, phenomic, clinical, and epidemiological data to support the development of treatment strategies and novel antimicrobial agents. The key issues addressed include data quality, model interpretability, external validation, regulatory requirements, privacy, and fairness. While AI is not a complete solution to AMR, it can certainly strengthen the global AMR response by complementing key areas of AMR such as antimicrobial stewardship, infection prevention, laboratory diagnostics, and global surveillance.

The Portuguese exploration of sub-Saharan Africa in the 15th and 16th centuries marked a crucial point both for geographical discovery and for the development of early naval medicine. This article looks at the health challenges faced by explorers from the time of Henry the Navigator (1394-1460) onwards, focusing on the infectious diseases that emerged on first contact with West Africa. Italian explorers such as Alvise Cadamosto and Antoniotto Usodimare provided valuable accounts of early expeditions in which they emphasized the occurrence of febrile diseases in the swampy coastal regions. These encounters showed the double threat of infections on board and off the ship. The article also highlights the Portuguese response to the pathogenic barriers encountered. While medical care was initially neglected, the continuing loss of labour prompted the empire to gradually deploy medical professionals on board and in the colonies. Over time, Portugal established hospitals and lazarettos and standardised medical training and licensing under King Manuel I. These early efforts to formalise medical care laid the foundations for colonial healthcare systems and early forms of public healthcare. Although these adaptations are still a long way from modern tropical medicine, they represent fundamental steps towards organised health care in the overseas territories and reflect the shift from pure exploration objectives to institutionalised support for the survival of imperial ventures.

Candidemia remains a significant healthcare-associated infection characterized by high mortality rates and considerable resource utilization. While echinocandins are established as first-line treatment, extended daily intravenous administration often delays patient discharge, particularly when transitioning to oral azoles is not feasible. Rezafungin, a novel long-acting echinocandin, offers once-weekly dosing with predictable pharmacokinetics. This prospective observational pilot study examined consecutive cases of guideline-defined catheter-related candidemia (CRC) diagnosed in medical wards at two Italian hospitals in 2025. All subjects initially received short-acting echinocandin therapy alongside catheter removal for source control. Upon meeting predefined clinical and microbiological stability criteria, patients were administered a single dose of rezafungin on day 7. Primary outcomes included clinical success and microbiological clearance at 30 days. Secondary endpoints encompassed reductions in hospital length of stay, relapse rates, mortality, and adverse drug events. Seven patients received rezafungin as consolidation therapy. The cohort was characterized by advanced age and a high comorbidity burden. Microbiological eradication was achieved in all cases. No drug-related adverse events, relapses, or deaths were observed at 30- and 90-day follow-up. The median estimated decrease in hospital stay was four days, translating to 28 bed-days saved. This real-world pilot cohort demonstrated that a stepwise antifungal strategy incorporating rezafungin following initial echinocandin therapy is feasible, well-tolerated, and associated with favorable short-term outcomes. Such an approach may facilitate earlier patient discharge, mitigate vascular-access issues, and support more efficient management of catheter-related candidemia. Larger, multicenter controlled studies are necessary to verify the clinical, economic, and sustainability benefits.