During 2025, the United States recorded the highest number of measles cases since measles elimination was declared in 2000. On March 21, 2025, Lubbock Public Health (LPH) in Texas received a report of a child care attendee aged 3 years, with fever, rash, cough, coryza, conjunctivitis, otitis media, and diarrhea who received a positive test result for measles by real-time reverse transcription-polymerase chain reaction (RT-PCR). Six additional children who attended the same child care facility and the grandfather of one of the children were confirmed by RT-PCR testing to have measles. None of the patients was reported to have traveled. LPH contacted the pediatric patients' caregivers to conduct case investigations and provided recommendations to the child care facility for home isolation, vaccination, and testing. LPH also communicated with caregivers, other child care facilities in the area, and the public to raise awareness. The child care facility implemented measures to minimize transmission, including separating children who were not yet eligible for the measles, mumps, and rubella vaccine; minimizing the use of shared spaces; and monitoring signs and symptoms. Collaboration between public health and community partners such as child care facilities can facilitate a rapid response and control of infectious disease outbreaks.

The GLIM malnutrition diagnostic framework includes the etiologic criterion for reduced dietary intake or assimilation (i.e., digestion or absorption). This criterion required further specification to support consistent use in clinical practice. Three rounds of a modified Delphi was undertaken to develop consensus on guidance to support identification of this criterion. A working group (n = 11) developed surveys iteratively. Invited global experts with diverse disciplines and practice contexts (n = 30) fully completed surveys; consensus was determined at 75% agreement. Three surveys and rounds of voting resulted in 15 guidance statements. Notable points include: (a) using usual intake as the comparator for reduced dietary intake rather than energy requirement, (b) use of gastrointestinal symptoms and nutrition impact symptoms to determine challenges with absorption or assimilation, rather than solely gastrointestinal conditions, and (c) using clinical judgment to determine severity of these symptoms. The final criterion is "less than or equal to 50% dietary intake in the last week or any reduction in intake greater than 2 weeks OR severe gastrointestinal or nutrition impact symptoms (e.g., dysphagia, nausea, vomiting, diarrhea) as a result of an acute or chronic condition or therapy." Future work should confirm the feasibility of this criterion in clinical practice and its criterion validity within the GLIM framework.

Klebsiella pneumoniae is an opportunistic pathogen associated with both community-acquired and nosocomial infections. Multidrug-resistant (MDR) strains are increasingly implicated in urinary tract infections (UTIs), traveller's diarrhoea, bacteraemia, and sepsis. β-lactam antibiotics are commonly used for treatment; however, antimicrobial resistance has emerged largely due to the production of extended-spectrum β-lactamases (ESBLs), which confer resistance mainly to penicillins, oxyimino-cephalosporins, and monobactams, while cephamycins and carbapenems usually remain stable to ESBL-mediated hydrolysis and compromise therapeutic efficacy. ESBL-producing strains represent a major cause of severe Gram-negative infections. This study aimed to determine the prevalence of ESBL-producing K. pneumoniae among UTI patients in Jordanian hospitals (Al Mafraq, Ma'an, and Islamic Hospitals), evaluate their antimicrobial susceptibility patterns, and detect antimicrobial resistance genes at the molecular level. A total of 450 urine isolates of K. pneumoniae were collected from UTI patients between November 2023 and May 2024. Isolates were identified in hospital laboratories using standard microbiological methods. Antimicrobial susceptibility testing was performed, and molecular characterisation of ESBL-associated genes was conducted using polymerase chain reaction (PCR). Out of 450 K. pneumoniae isolates collected from UTI patients across three Jordanian regions, 72 (16%) were confirmed as ESBL producers. Among the 72 ESBL-positive K. pneumoniae isolates, 34 (47.2%) were recovered from the Central region, 20 (27.8%) from the North, and 18 (25.0%) from the South. Molecular analysis revealed that 41.7% of ESBL-producing isolates carried the blaCTX-M gene, while 33.3% harboured the blaOXA gene. All ESBL-producing isolates demonstrated antimicrobial resistance to third-generation cephalosporins. A significantly higher proportion of ESBL-producing isolates was identified in female patients (84.7%) compared with males (15.3%). A significant association was observed between blaOXA gene distribution and geographic region (p = 0.016), whereas blaCTX-M gene distribution showed no significant regional association. ESBL-producing K. pneumoniae accounted for a substantial proportion of UTI isolates in Jordan, with blaCTX-M identified as the predominant resistance gene. The higher burden observed in the Central region and among female patients highlights notable distribution patterns in this cohort. These findings emphasise the necessity for sustained molecular surveillance and strengthened antimicrobial stewardship strategies to limit the dissemination of ESBL-producing strains in Jordanian healthcare settings.

While most gastrointestinal stromal tumors are driven by oncogenic mutations in KIT or PDGFRA, 10-15% exhibit functional loss of the succinate dehydrogenase (SDH) complex and genome-wide DNA hypermethylation. Excess methylation in SDH-deficient gastrointestinal stromal tumors disrupts genomic insulators, inducing aberrant expression of oncogenic ligands FGF3, FGF4, and activating an autocrine signaling loop mediated through FGFR1. We conducted a phase 2 trial of pan-fibroblast growth factor receptor inhibitor rogaratinib in patients with sarcoma and report here on the cohort of patients with advanced SDH-deficient GIST. The primary objective was to estimate objective response rate. Secondary objectives were to estimate progression-free survival (PFS) and assess safety and tolerability. Exploratory objectives were to evaluate serial measurements of FGF3 and FGF4 and fibroblast growth factor receptors in serial biopsies, to perform whole-exome sequencing in serial biopsies and to explore rogaratinib exposure with pharmacodynamic effects. Twenty-four patients received rogaratinib and ten experienced partial responses for an objective response rate of 41.7%. Median PFS was 31.0 months (95% confidence interval 20.2-not reached), and 1-year PFS was 77.4% (95% confidence interval 61.7-97.1). Toxicities were manageable and included hyperphosphatemia, fatigue and diarrhea. Elevations in phosphorous were seen across the cohort, consistent with target engagement of FGFR1. Whole-exome and next-generation sequencing revealed alterations in the SDH subunit coding genes (SDHx) as expected. This trial illustrates a successful demonstration of targeted cancer therapy predicated on an epigenetic mechanism of oncogene activation. Clinicaltrials.gov identifier: NCT04595747 .

Enterotoxigenic Escherichia coli (ETEC) is a major cause of diarrhoea in children, adults and travellers in endemic regions. ETEC pathogenesis is mediated by heat-labile (LT) and heat-stable (ST) enterotoxins together with colonization factors. In this study, we characterized the chromosomal and plasmid features of twelve ETEC lineage 2 (L2) isolates, including five isolates sequenced by long-read PacBio technology and reported for the first time in this study, and seven publicly available complete genomes. Comparative genomic analysis revealed a highly conserved chromosomal backbone and two core plasmids, with the CS2 operon uniquely integrated into the chromosome, while other virulence determinants, including LT, ST, CS3, EatA, CS21, and EtpBAC remained plasmid-encoded. Fusion and consolidation of lineage 1-like plasmids produced a streamlined plasmidome in L2, preserving essential virulence genes while occasionally incorporating antibiotic resistance determinants. Phage-like plasmids were identified sporadically, highlighting ongoing horizontal gene acquisition. These findings demonstrate that ETEC L2 employs a hybrid virulence architecture combining chromosomal fixation of a key colonization factor with plasmid-mediated accessory traits, potentially enhancing stability and transmissibility. The study provides new insights into the genomic organization, evolutionary dynamics, and pathogenic potential of this emerging ETEC lineage.