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Germs, Volume 16, Issue 2 (June 2026) – 5 articles

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16 pages, 566 KB  
Article
Bridging Knowledge–Practice Gaps in Syphilis Prevention: A Nationwide, Online Cross-Sectional Survey of Knowledge, Attitudes, Practices, and Policy Acceptance in Saudi Arabia
by Hind Muteb Albadrani
Germs 2026, 16(2), 13; https://doi.org/10.3390/germs16020013 - 11 May 2026
Viewed by 4
Abstract
Introduction: Syphilis is a preventable sexually transmitted infection (STI) with severe health outcomes, yet it is not included in Saudi Arabia’s national premarital and antenatal STI screening programs. This study assessed knowledge, attitudes, and practices (KAP) toward syphilis in Saudi Arabia and identified [...] Read more.
Introduction: Syphilis is a preventable sexually transmitted infection (STI) with severe health outcomes, yet it is not included in Saudi Arabia’s national premarital and antenatal STI screening programs. This study assessed knowledge, attitudes, and practices (KAP) toward syphilis in Saudi Arabia and identified predictors of acceptance for including syphilis testing in such programs. Methods: A cross-sectional online survey was conducted among 935 participants aged ≥20 years. Data included sociodemographic characteristics and measures of KAP and screening acceptance. Continuous variables were summarized as medians (IQR) and categorical variables as frequencies and percentages, with bivariate and multivariate logistic regression used to identify predictors of screening acceptance. Results: Knowledge and preventive practices were low, while attitudes were predominantly neutral (median attitude score: 34 IQR 32–38). Although intentions for personal testing were low (17%), support for syphilis testing in premarital (60.8%) and antenatal (48.9%) programs was considerable. Employment in the health sector, older age, and positive attitudes predicted acceptance of screening policies. Knowledge and practice showed a weak correlation (r = 0.14), whereas knowledge and attitude were moderately correlated (r = 0.55). Conclusion: KAP toward syphilis is influenced by specific sociodemographic factors. Although acceptance of screening is high at the policy level, individual-level preventive behaviors remain low. Full article
31 pages, 2481 KB  
Review
Decoding Norovirus Biology: Insights into Epidemiology, Structural Dynamics, Host Interactions, and Viral Replication
by Mudra Sikenis, Bhavna Prajapati, Ashutosh Kumar Singh, Karmveer Yadav, Ashish Kumar Vyas, Narapity Pathirannehalage Sunil-Chandra, Akansha Tandekar, Surya Singh, Tarun Patil, Subhabrata Kar, Rajnarayan R. Tiwari and Ram Kumar Nema
Germs 2026, 16(2), 12; https://doi.org/10.3390/germs16020012 - 11 May 2026
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Abstract
Norovirus is the leading cause of acute infectious gastroenteritis in the world and accounts for a significant proportion of outbreaks at the food-borne and person-to-person levels. Due to their low infectious dose, persistence in the environment, and broad genetic diversity, they can quickly [...] Read more.
Norovirus is the leading cause of acute infectious gastroenteritis in the world and accounts for a significant proportion of outbreaks at the food-borne and person-to-person levels. Due to their low infectious dose, persistence in the environment, and broad genetic diversity, they can quickly spread and reappear in even the most diverse populations. This review integrates current knowledge on the epidemiology of noroviruses, genomic organization, structural biology, virus–host interactions, and replication mechanisms, with a focus on factors that determine virus evolution and strain dominance. Literature has been systematically searched in the PubMed and Scopus databases to incorporate recent experimental and epidemiological findings. Analysis of global surveillance data indicates ongoing genetic diversification of circulating strains, with periodic replacement of major variants, particularly the GII.4 lineage. Variability of the capsid and recognition of histo-blood Group Antigens strongly affects the host’s susceptibility, viral attachment and immune escape. The capsid consists of most of the viral protein complexes. The structural proteins VP1 and VP2 are responsible for determining the contours of the capsid and antigenic specificity. Non-structural proteins are responsible for coordinating the genome replication and the modification of host cell pathways to favor the production of the virus. Eliminating these gaps by means of integrated genomic surveillance and functional studies will provide insight into the evolution of norovirus and help to develop broadly effective vaccines and antiviral strategies. Full article
3 pages, 161 KB  
Editorial
Editorial Judgment in Infectious Diseases
by Terenzio Cosio
Germs 2026, 16(2), 11; https://doi.org/10.3390/germs16020011 - 7 May 2026
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Abstract
Infectious diseases have become increasingly dependent on diagnostic systems, whose reach have expanded, largely through advances in clinical microbiology, far more quickly than efforts to verify the reliability and accurate interpretation of their findings [...] Full article
18 pages, 1742 KB  
Article
Microbial Contamination in Hard-Shell Capsule Traditional Medicines and Health Supplements in Malaysia: GMP Regulatory Oversight and Encapsulation Practices
by Muhammad Amirul Amil, Jun Hao Koo, Xin Yun Yah, Norizzati Adila Salam and Muhammad Mawardi Zakaria
Germs 2026, 16(2), 9; https://doi.org/10.3390/germs16020009 - 9 Apr 2026
Viewed by 750
Abstract
Introduction: The growing demand for traditional medicines and health supplements (TMHS) in Malaysia has raised concerns regarding microbial contamination in hard-shell capsule products. Despite regulatory oversight, recurring recalls highlight persistent non-compliance with Good Manufacturing Practice (GMP) standards. This study examines the risks [...] Read more.
Introduction: The growing demand for traditional medicines and health supplements (TMHS) in Malaysia has raised concerns regarding microbial contamination in hard-shell capsule products. Despite regulatory oversight, recurring recalls highlight persistent non-compliance with Good Manufacturing Practice (GMP) standards. This study examines the risks of microbial contamination, recall patterns, and encapsulation practices among TMHS hard-shell capsule manufacturers in Malaysia. Methods: A cross-sectional approach was employed, comprising a review of regulatory guidelines, analysis of NPRA recall data from 2020 to 2024, and a structured survey of 86 TMHS manufacturers on equipment and production parameters. Results: Review of GMP guidance indicated that greater automation and reduced manual handling in capsule-filling processes help minimise microbial contamination. In line with this, TMHS products were recalled at a rate of 4.73%, more than 4 times the pharmaceutical recall rate (1.09%). Among the 245 TMHS recalls, 68 involved hard-shell capsule products that failed microbial testing, primarily total aerobic microbial count (73.53%). Additionally, manufacturers with 50–100 registered products had significantly higher odds of recall (OR = 10.0, 95% CI: 2.35–42.47). However, no significant associations were found between recall status and equipment type, capsule size, or production frequency. Conclusions: Microbial contamination remains a critical issue in TMHS hard-shell capsule products. Regulatory efforts should focus on medium-scale manufacturers and reinforce risk-based GMP adherence to enhance product safety and public health protection. Full article
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10 pages, 474 KB  
Article
The Characteristics of the Main Nontuberculous Mycobacteria Species Among Patients with HIV at a Single Center in Poland
by Jakub Młoźniak, Adam Szymański, Gabriela Stondzik, Dagny Clea Krankowska, Tomasz Mikuła, Agnieszka Lembas, Joanna Kozłowska, Regina Podlasin, Magdalena Thompson, Grażyna Cholewińska, Aleksandra Chylak-Nowosielska, Anna Zabost, Ewa Augustynowicz-Kopeć and Alicja Wiercińska-Drapało
Germs 2026, 16(2), 10; https://doi.org/10.3390/germs16020010 - 9 Apr 2026
Viewed by 308
Abstract
Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms capable of causing diverse clinical manifestations. Their epidemiology among people with HIV remains insufficiently characterized. This study examined the epidemiology of NTM among people with HIV admitted to the Hospital for Infectious Diseases in Warsaw between [...] Read more.
Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms capable of causing diverse clinical manifestations. Their epidemiology among people with HIV remains insufficiently characterized. This study examined the epidemiology of NTM among people with HIV admitted to the Hospital for Infectious Diseases in Warsaw between 2017 and 2023. Data on CD4+ T-cell counts, type of NTM involvement, species identification, and antimicrobial resistance were obtained from medical records. In the analyzed group the median of the CD4+ T-cell count was 25 cells/mm3 (IQR 65 cells/mm3). Late HIV diagnosis was observed in n = 45/50 (90.0%) patients. NTM colonization was identified in n = 20 (33.9%) patients, while n = 39 (66.1%) had active NTM disease, including pulmonary (53.9%), disseminated (41.0%), and extrapulmonary (5.1%) forms. Mycobacterium kansasii was the most common species among colonized patients, n = 7/24 (29.2%), whereas Mycobacterium avium predominated among patients with NTM disease, n = 30/42 (71.4%). Among patients with NTM disease, in vitro resistance to at least one antimicrobial agent was observed in 80.0% of M. avium isolates. High levels of resistance of M. avium were noted for ethambutol (n = 8/8, 100%), moxifloxacin (n = 16/22, 72.8%) and linezolid (n = 9/21, 42.9%). Proper identification of Mycobacterium species and its antibiotic resistance might be helpful in selecting effective antimicrobial therapy. Early HIV diagnosis is needed to prevent NTM disease. Full article
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