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18 pages, 341 KB  
Article
In Silico Mutational Analysis of Two-Component System Genes Associated with Colistin Resistance in Clinical Pseudomonas aeruginosa Isolates from Peshawar
by Bashir Ahmad, Qaisar Ali, Sadiq Azam, Muhammad Asghar, Noor Rehman, Gul-e-Sehra Mujib, Syed Sohail Shah, Jamila Javed, Ibrar Khan, Taj Ali Khan and Taane G. Clark
Biomolecules 2026, 16(7), 962; https://doi.org/10.3390/biom16070962 (registering DOI) - 29 Jun 2026
Abstract
Pseudomonas aeruginosa is an opportunistic pathogen causing healthcare-associated infections. Colistin is a last-resort antibiotic for multidrug-resistant Gram-negative bacteria. Resistance arises through mutations in two-component systems (TCS) regulating the arn operon. Data on colistin resistance in P. aeruginosa from Pakistan remain limited. A total [...] Read more.
Pseudomonas aeruginosa is an opportunistic pathogen causing healthcare-associated infections. Colistin is a last-resort antibiotic for multidrug-resistant Gram-negative bacteria. Resistance arises through mutations in two-component systems (TCS) regulating the arn operon. Data on colistin resistance in P. aeruginosa from Pakistan remain limited. A total of 3189 clinical samples (urine, blood, sputum, pus, wound swabs) were cultured. P. aeruginosa was identified by Gram staining, biochemical tests (catalase, oxidase, API 20E), and oprL gene amplification. Antibiotic susceptibility was determined by disk diffusion and MIC strips. Resistance genes (PhoP, PhoQ, PmrA, PmrB, mcr-1, oprD) were detected by PCR and Sanger sequencing. Wild-type protein structures were retrieved from PDB; mutant structures were predicted using AlphaFold3. ANP (phosphoaminophosphonic acid-adenylate ester) was docked using MOE 2019.0102. Of 3189 samples, 384 (12.0%) yielded P. aeruginosa. Wound/pus (38.0%) and surgical wards (30.0%) were the predominant sources. Colistin and polymyxin B showed 99.0% susceptibility (MIC50/MIC90 = 1 µg/mL). High resistance was observed for Piperacillin–Tazobactam (96.4%), Aztreonam (70.6%), and Gentamicin (64.2%). oprD was the most prevalent gene (87.5%), followed by PmrB (54.0%), PhoQ (44.0%), PhoP (36.0%), PmrA (18.0%), and mcr-1 (8.0%). Docking revealed the strongest binding in wild-type PhoQ (1ID0; −12.0 kcal/mol, LYS392), wild-type PmrB (2JSO; −9.8 kcal/mol, ASP37), and wild-type PhoP (2PKX; −9.1 kcal/mol, LYS87/ARG111). Mutant proteins showed reduced binding affinities and dispersed interaction networks. Mutant PhoP formed 16 contacts (strongest −4.3 kcal/mol) versus wild-type PhoP with 13 contacts (−9.1 kcal/mol). Colistin remains highly effective against P. aeruginosa in this setting (99.0% susceptibility). The presence of mcr-1 (8.0%) and high oprD prevalence (87.5%) require continued surveillance. Mutations in TCS proteins reduce ANP binding affinity and alter interaction specificity, suggesting that ATP-competitive inhibitors targeting these kinases merit further investigation and experimental validation. Full article
(This article belongs to the Section Bioinformatics and Systems Biology)
25 pages, 7196 KB  
Article
Phytochemical Analysis, Antimicrobial, and Antioxidant Activities of North Macedonia Achillea setacea Essential Oil
by Antonella Porrello, Alessia Sordillo, Giusy Castagliuolo, Dario Antonini, Gianfranco Fontana, Natale Badalamenti, Mario Varcamonti, Maurizio Bruno, Vincenzo Ilardi and Anna Zanfardino
Antioxidants 2026, 15(7), 820; https://doi.org/10.3390/antiox15070820 (registering DOI) - 29 Jun 2026
Abstract
The complex genus Achillea L. comprises more than 140 species distributed widely throughout the Northern Hemisphere. Several species are widely used in traditional medicine for their therapeutic properties, yet few studies have correlated their biological properties with the plant’s phytochemical composition. Among these, [...] Read more.
The complex genus Achillea L. comprises more than 140 species distributed widely throughout the Northern Hemisphere. Several species are widely used in traditional medicine for their therapeutic properties, yet few studies have correlated their biological properties with the plant’s phytochemical composition. Among these, Achillea setacea Waldst. & Kit. is a perennial species traditionally used to treat digestive and inflammatory disorders. In this study, the essential oil of A. setacea, collected wild in North Macedonia, was analyzed spectrometrically and spectroscopically by GC-MS and NMR, respectively. A total of nineteen compounds were identified, with camphor (31.3%), 4-terpineol (11.3%), and eucalyptol (10.6%) being the main constituents. Furthermore, the biological activities of pure oil were evaluated, showing notable antioxidant properties, as well as antimicrobial effects against a panel of clinically relevant microorganisms, including Gram-positive and Gram-negative bacteria. Furthermore, its impact on human intestinal epithelial (Caco-2) cells was assessed, highlighting its potential relevance for gastrointestinal applications, in agreement with the traditional use of Achillea species for digestive disorders. Full article
23 pages, 22562 KB  
Article
The Natural Phloroglucinol α-Pyrone Arzanol Protects HaCaT Keratinocytes from Lipopolysaccharide and Polyriboinosinic-Polyribocytidylic Acid-Induced Damage and Promotes Reparative Mechanisms
by Franca Piras, Valeria Sogos, Aurora Camola, Federica Pollastro and Antonella Rosa
Appl. Sci. 2026, 16(13), 6472; https://doi.org/10.3390/app16136472 (registering DOI) - 29 Jun 2026
Abstract
The protective effect of arzanol, a natural prenylated phloroglucinol α-pyrone from the Helichrysum microphyllum subsp. tyrrhenicum, was investigated in HaCaT keratinocytes exposed to two inflammatory stimuli: lipopolysaccharide (LPS, 0.5–75 µg/mL), a component of gram-negative bacteria, and polyriboinosinic-polyribocytidylic acid (poly I:C, 0.5–50 µg/mL), [...] Read more.
The protective effect of arzanol, a natural prenylated phloroglucinol α-pyrone from the Helichrysum microphyllum subsp. tyrrhenicum, was investigated in HaCaT keratinocytes exposed to two inflammatory stimuli: lipopolysaccharide (LPS, 0.5–75 µg/mL), a component of gram-negative bacteria, and polyriboinosinic-polyribocytidylic acid (poly I:C, 0.5–50 µg/mL), a synthetic viral RNA analog. LPS and poly I:C significantly decreased HaCaT cell viability (18–93% reduction in the 5–75 μg/mL LPS range and 25% at 50 μg/mL poly I:C, MTT assay) and increased apoptosis and cell death (NucView 488 and propidium iodide assay) after 3 h and 24 h of exposure. Arzanol (1 h of pre-incubation, 5–25 μM) showed a significant protective effect against LPS and poly I:C-induced damage, preserving cell viability (25% of viability increase at 5 μg/mL LPS concentration, and 30% at 50 μg/mL of poly I:C) and decreasing apoptosis/cell death. Western blot analysis demonstrated the ability of arzanol (5 μM) to reduce the apoptotic protein Bax and the inflammatory cytokine IL-1β levels in HaCaT keratinocytes exposed for 3 h to 5 and 10 μg/mL LPS. Moreover, scratch assay showed the arzanol reparative effect on HaCaT cells. Our results qualified arzanol as a protective drug for dermatological applications in human skin diseases. Full article
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15 pages, 609 KB  
Article
Growth-Inhibitory Activity of Raw and Pasteurized Donkey Milk Against Clinically Relevant Gram-Negative Isolates with Different Antimicrobial Resistance Profiles
by Anika Trudić, Ljubiša Šarić, Dragana Plavšić, Olja Todorić, Miloš Pelić, Ivana Čabarkapa and Dragana Tomanić
Animals 2026, 16(13), 1996; https://doi.org/10.3390/ani16131996 (registering DOI) - 29 Jun 2026
Abstract
Antimicrobial resistance (AMR) is a major global health challenge affecting human and animal health, food safety, and the effectiveness of antimicrobial therapy. Therefore, this study evaluated the antimicrobial activity of raw (RDM) and pasteurized donkey milk (PDM) against clinically relevant Gram-negative bacteria with [...] Read more.
Antimicrobial resistance (AMR) is a major global health challenge affecting human and animal health, food safety, and the effectiveness of antimicrobial therapy. Therefore, this study evaluated the antimicrobial activity of raw (RDM) and pasteurized donkey milk (PDM) against clinically relevant Gram-negative bacteria with different AMR profiles. Antimicrobial activity against ten clinical Enterobacterales isolates, including CTX-M-, OXA-48-, KPC-, NDM-, and VIM-producing strains, was assessed by monitoring bacterial growth kinetics in artificially contaminated milk samples during 8 h of incubation at 37 °C. Pasteurized cow milk (CM) and nutrient broth (NB) served as controls. The strongest antimicrobial effects were observed against OXA-48-producing Klebsiella pneumoniae A4 and CTX-M-producing Escherichia coli A1, whereas Citrobacter koseri F5 showed the lowest susceptibility. After 8 h, K. pneumoniae A4 counts remained below 2 log CFU/mL in RDM compared with >6 log CFU/mL in NB. Significant effects of milk type, incubation time, and their interaction on bacterial growth were confirmed (p < 0.001). Donkey milk significantly inhibited bacterial growth compared with NB and CM, while some differences between RDM and PDM were observed depending on the bacterial isolate. These findings support donkey milk as a bioactive matrix with potential antimicrobial applications. Full article
(This article belongs to the Special Issue Donkey Milk: Nutritional Potential, Safety, and Novel Applications)
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21 pages, 4713 KB  
Review
Flavonoids as Potential Therapeutic Agents Against Gastrointestinal Pathogen Growth and Their Mechanisms of Action: A Comprehensive Review
by Muhammad Jawad Yousaf Zai and Ian Edwin Cock
Molecules 2026, 31(13), 2265; https://doi.org/10.3390/molecules31132265 (registering DOI) - 29 Jun 2026
Abstract
The increasing prevalence of gastrointestinal infections, along with growing resistance to conventional antibiotics, has driven the search for alternative antibacterial agents including flavonoids, which are widely recognised for their antimicrobial properties. Flavonoids exhibit broad-spectrum antimicrobial activity against both Gram-positive and Gram-negative bacteria through [...] Read more.
The increasing prevalence of gastrointestinal infections, along with growing resistance to conventional antibiotics, has driven the search for alternative antibacterial agents including flavonoids, which are widely recognised for their antimicrobial properties. Flavonoids exhibit broad-spectrum antimicrobial activity against both Gram-positive and Gram-negative bacteria through multifactorial mechanisms, disrupting multiple bacterial cellular processes, including energy metabolism, membrane integrity, and protein synthesis. Several studies have highlighted the antimicrobial potential of flavonoids against gastrointestinal pathogens, with some evidence suggesting minimal disruption to beneficial intestinal microflora. Most investigations have primarily focused on in vitro assessments of antibacterial activity, with limited in vivo studies and insufficient therapeutic or clinical evaluation. Consequently, their efficacy in physiological systems and the underlying mechanisms of action remain inadequately understood. Studies should also examine the antimicrobial activity of flavonoids against a wider panel of gastrointestinal pathogens. Also, the panel of flavonoids previously evaluated for their antibacterial activity is relatively narrow and many compounds have been neglected to date. Multiple other flavonoids remain to be evaluated for antimicrobial activity against gastrointestinal pathogens. This review focuses on the antimicrobial activity of different classes of flavonoids against gastrointestinal pathogens. Additionally, we discuss the interaction of selected flavonoids with conventional antibiotics. Furthermore, their mechanisms of action (where known) are also discussed to focus attention on the use of this important class of molecules as antibiotic therapies. Full article
(This article belongs to the Special Issue Natural Products and Microbiology in Human Health, 2nd Edition)
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16 pages, 969 KB  
Article
The Epidemiology of Multidrug-Resistant Pathogens in Hematopoietic Stem Cell Transplantation (HSCT) Patients: A Five-Year Retrospective Study at a Cancer Center
by Sawsan Mubarak, Joud Jarrah, Yara K. Edor, Omar Khresat and Hadeel AlGhawrie
Pathogens 2026, 15(7), 684; https://doi.org/10.3390/pathogens15070684 (registering DOI) - 28 Jun 2026
Abstract
Multidrug-resistant (MDR) pathogens present a significant threat to hematopoietic stem cell transplant (HSCT) recipients; despite their critical implications, regional data on their infection patterns remain scarce. This study aimed to characterize the incidence, pathogen and antimicrobial resistance distribution of clinically confirmed bacterial infections [...] Read more.
Multidrug-resistant (MDR) pathogens present a significant threat to hematopoietic stem cell transplant (HSCT) recipients; despite their critical implications, regional data on their infection patterns remain scarce. This study aimed to characterize the incidence, pathogen and antimicrobial resistance distribution of clinically confirmed bacterial infections among HSCT recipients. A retrospective analysis was conducted at King Hussein Cancer Center, Jordan (2018–2022). MDR pathogens were defined per CDC criteria. During the study period, 1157 HSCT procedures were performed. A total of 327 patients developed clinically documented bacterial infections, yielding an overall cumulative incidence of 28.3%, with a higher burden in the pediatric cohort (34.7%), including exclusive identification of Klebsiella oxytoca in pediatrics (2.3%). Gram-negative bacteria dominated, with Escherichia coli (50.5%) and Klebsiella pneumoniae (22.0%) being most common. Extended-spectrum beta-lactamase (ESBL) production was the dominant resistance mechanism (71.3%), followed by carbapenem-resistant Enterobacteriaceae (CRE; 14.1%), methicillin-resistant Staphylococcus aureus (MRSA; 8.6%), and carbapenem-resistant Pseudomonas aeruginosa (CRPA; 7.0%). The urogenital (39.1%) and bloodstream (31.2%) were the most infected sites. Significant site-specific associations were noted for ESBL production, MDR-Acinetobacter baumannii (p < 0.001) and MRSA (p = 0.007). Temporal analysis revealed a convergent MDR peak in 2021. Our findings offer critical insights into MDR pathogen incidence in HSCT recipients in the Middle East, informing improved infection management and intensified antimicrobial stewardship in this high-risk population. Full article
(This article belongs to the Special Issue Epidemiology of Bacterial Pathogens)
29 pages, 5746 KB  
Article
Potentiation of Penicillin G and Selected β-Lactams with Quercetin Against Multidrug-Resistant Bacteria: Mechanistic Insights, Antibacterial Phytochemicals, and Toxicity Evaluation
by Gagan Tiwana, Ian Edwin Cock and Matthew James Cheesman
Int. J. Mol. Sci. 2026, 27(13), 5825; https://doi.org/10.3390/ijms27135825 (registering DOI) - 27 Jun 2026
Viewed by 141
Abstract
Antimicrobial resistance is increasing, necessitating the development of novel and efficacious therapies. Plants contain phytochemicals, some of which may possess antibacterial properties. This research employed broth dilution experiments to investigate the antibacterial efficacy of fifteen phytochemicals identified in medicinal plant extracts. The sum [...] Read more.
Antimicrobial resistance is increasing, necessitating the development of novel and efficacious therapies. Plants contain phytochemicals, some of which may possess antibacterial properties. This research employed broth dilution experiments to investigate the antibacterial efficacy of fifteen phytochemicals identified in medicinal plant extracts. The sum of fractional inhibitory concentration of phytochemicals in conjunction with reference antibiotics were also analysed. The inhibitory effects of phytochemicals against β-lactamase were evaluated to explore their potential mechanisms of action. The phytochemicals were evaluated for toxicity on human dermal fibroblast cells. Gallic acid and luteolin significantly inhibited Staphylococcus aureus and the methicillin-resistant S. aureus (MRSA) strain, with minimum inhibitory concentration (MICs) of 62.5 µg/mL. Gallic acid also demonstrated restricted efficacy against Gram-negative species, with MICs ranging from 312.5 to 1250 µg/mL. Gram-negative bacteria exhibited no response to luteolin. Ellagic acid, catechin, naringenin, and quercetin exhibited moderate antibacterial efficacy against the tested pathogens (625–2500 µg/mL MIC). Corilagin exhibited significant antibacterial activity against S. aureus and MRSA, with a MIC of 7.81 µg/mL. Corilagin also exhibited notable efficacy against Bacillus. cereus, Shigella flexneri, and Klebsiella pneumoniae, with MICs ranging from 62.5 to 250 µg/mL. Fractional inhibitory concentration studies revealed a synergistic effect between amoxicillin and corilagin against B. cereus. Additionally, catechin, luteolin, and quercetin synergised penicillin G against S. aureus. Quercetin potentiated the activity of β-lactams (amoxicillin, penicillin G, and oxacillin) against MRSA. Notably, these antibiotics were ineffective against MRSA alone. Isobologram analysis revealed potentiation between penicillin G and quercetin against MRSA at all tested ratios. The β-lactamase inhibitory activity of the phytochemicals was evaluated using a commercial screening kit, and the percentage of relative inhibition was determined. Quercetin and luteolin both inhibited β-lactamase, achieving relative inhibition rates of 77–100% across two-time intervals. All phytochemicals were nontoxic against human dermal fibroblasts. Indeed, quercetin enhanced cell survival by 200%. Full article
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19 pages, 1809 KB  
Article
Chemical Composition, and Antioxidant and Antimicrobial Properties of Monarda didyma L.’s Essential Oils and Hydrosols
by Patrycja Cichosz, Magdalena Walasek-Janusz, Agnieszka Grzegorczyk, Rafał Papliński, Piotr Kiczorowski and Renata Nurzyńska-Wierdak
Molecules 2026, 31(13), 2252; https://doi.org/10.3390/molecules31132252 - 26 Jun 2026
Viewed by 197
Abstract
Aromatic medicinal plants are a constant focus of interest for scientists and producers. One example is Monarda didyma L., an aromatic perennial with proven health benefits. During the distillation process, hydrophobic (essential oils) and hydrophilic (hydrosols) fractions were obtained from the leaves, flowers [...] Read more.
Aromatic medicinal plants are a constant focus of interest for scientists and producers. One example is Monarda didyma L., an aromatic perennial with proven health benefits. During the distillation process, hydrophobic (essential oils) and hydrophilic (hydrosols) fractions were obtained from the leaves, flowers and aerial parts (herb) of bee balm (M. didyma) in our study. The highest yield of essential oil (mL·100 g−1 DM) was obtained from the flowers, whilst the highest yield of hydrosol was obtained from the leaves (42.46 mL·100 g−1 DM). The dominant compound in both distillation products was thymol, with contents ranging from 51.55% to 68.63% (essential oils) and 90.31 to 100% (hydrosols). The essential oils that we analyzed were characterized by a higher polyphenol content than hydrolates. The highest polyphenol content among the essential oils was found in the flower essential oil (415.84 mg GAE·mL−1). All the essential oils tested were characterized by a high antioxidant activity (DPPH IC50 from 0.77 (leaf essential oil) to 0.92 μL (flower essential oil)). The essential oils tested also exhibited a broad spectrum of antimicrobial activity against Gram-positive and Gram-negative bacteria and yeasts, while hydrosols showed selective antifungal activity, without significant antibacterial activity. Full article
(This article belongs to the Special Issue Chemical Composition and Biological Evaluation of Essential Oils)
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18 pages, 1700 KB  
Article
Bacterial Community Dynamic Regulates Fermentation Quality and Mycotoxin Accumulation in Mulberry Silage Treated with Exogenous Lactic Acid Bacteria Inoculant and Cellulase Enzyme
by Yunhua Zhang, Yifan Chen, Lin Sun, Xuebing Yan, Siran Wang and Zhumei Du
Fermentation 2026, 12(7), 302; https://doi.org/10.3390/fermentation12070302 - 25 Jun 2026
Viewed by 111
Abstract
The global shortage of high-quality protein feed resources continues to widen, and the development of high-value-added woody plants is a key strategy for alleviating feed shortage. The mulberry (Morus alba L.) is a recognized high-protein woody forage resource. However, the inconsistent quality [...] Read more.
The global shortage of high-quality protein feed resources continues to widen, and the development of high-value-added woody plants is a key strategy for alleviating feed shortage. The mulberry (Morus alba L.) is a recognized high-protein woody forage resource. However, the inconsistent quality of its natural silage and the unclear risk of mycotoxins represent the core bottlenecks limiting its widespread adoption as feed. Four treatments were set up in this study: (1) control; (2) lactic acid bacteria inoculant (LAB, Lactiplantibacillus plantarum); (3) cellulase enzyme (AC, Acremonium cellulolyticum); (4) a mixture of LAB + AC. After 60 days of ensiling, a systematic analysis was conducted to examine the effects of exogenous microbial inoculant and enzyme preparation on the fermentation quality, bacterial community, and mycotoxin in mulberry silages. Fresh mulberry exhibited a high crude protein content of 23% on a dry matter (DM) basis, making it a high-quality feed resource. Compared to the control, the addition of LAB and AC either alone or in combination, significantly improved (p < 0.001) the fermentation quality and safety of silages: lactic acid content increased from 0.85% DM to 1.41–2.03% DM; pH, ammonia nitrogen, and deoxynivalenol decreased from 4.85, 0.88% DM, and 3.92 μg/kg to 3.53–3.95, 0.40–0.55% DM, and 1.21–3.04 μg/kg, respectively. The combined LAB and AC treatment resulted in the most favorable fermentation performance of mulberry silage. Bacterial community analysis revealed that fresh mulberry exhibited high bacterial alpha diversity, with Gram-negative bacteria as the dominant bacterial community, and Sphingomonas roseiflava as a representative dominant species. After ensiling, bacterial alpha diversity decreased in all the silages. Furthermore, the Lactiplantibacillus plantarum eventually prevailed as the dominant bacteria and exhibiting the highest relative abundance in the LAB + AC-treated silage (57.23%). Bugbase functional prediction indicated that the proportion of potential pathogenic bacteria was significantly higher (p < 0.05) in fresh mulberry than silage. Thus, the synergistic action of LAB + AC treatment effectively optimized the ensiling fermentation process. Full article
19 pages, 5646 KB  
Article
Changes in Antimicrobial Resistance Patterns in Intensive Care Units Following the COVID-19 Pandemic: A 10-Year Retrospective Study from Türkiye
by Ayşe Çapar, Derya Özyiğitoğlu, Şeyma Başlılar, Mürşide Efil Erdoğan, Beril Balak, Betül Nur Doğan, Öznur Hun Aktaş and Ebru Korkmaz
Antibiotics 2026, 15(7), 636; https://doi.org/10.3390/antibiotics15070636 (registering DOI) - 25 Jun 2026
Viewed by 130
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic coincided with substantial changes in healthcare delivery and antimicrobial resistance (AMR) patterns worldwide, particularly in intensive care units (ICUs), where invasive procedures and broad-spectrum antibiotics are commonly used. Data from Türkiye remains limited. Methods: This retrospective [...] Read more.
Background: The coronavirus disease 2019 (COVID-19) pandemic coincided with substantial changes in healthcare delivery and antimicrobial resistance (AMR) patterns worldwide, particularly in intensive care units (ICUs), where invasive procedures and broad-spectrum antibiotics are commonly used. Data from Türkiye remains limited. Methods: This retrospective observational study evaluated bacterial and fungal isolates from adult ICU patients at a tertiary hospital from 2016 to 2025. Microorganisms were identified, and antimicrobial susceptibility testing was performed using standardized methods. Resistance patterns were compared between the pre-pandemic (January 2016–February 2020) and post-pandemic (March 2020–May 2025) periods. Results: A total of 2666 patients and 5433 isolates were analyzed. Gram-negative pathogens showed marked increases in resistance: carbapenem and colistin resistance in Klebsiella pneumoniae were significantly higher in the post-pandemic period (69.6% vs. 44.4% and 60.5% vs. 22.5%, respectively; p < 0.001). Resistance rates to multiple antimicrobial agents also increased in Acinetobacter baumannii and Pseudomonas aeruginosa (p < 0.05). Among Gram-positive bacteria, vancomycin-resistant Enterococcus faecium increased from 10% to 47.1%. Candida auris emerged only in the post-pandemic period, showing high resistance to fluconazole (75%) and amphotericin B (36.7%). Conclusions: Significant differences in AMR patterns were observed between the pre- and post-pandemic periods in this ICU population. Higher resistance rates were observed among several clinically important bacterial pathogens, and Candida auris emerged exclusively during the post-pandemic period. Given the study’s observational design, these findings should be interpreted as temporal associations rather than evidence of a causal effect of the COVID-19 pandemic. Continued antimicrobial stewardship and infection-control measures remain essential to address the growing burden of AMR. Full article
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20 pages, 1108 KB  
Article
From Gram-Negative Neonatal Sepsis to Neurodevelopmental Impairment: A Retrospective Cohort Study in Preterm Infants
by Mihaela Zaharie, Marioara Boia, Aniko Manea, Roxana Maria Jeleriu, Mirabela Adina Dima, Ileana Enatescu and Daniela Iacob
Children 2026, 13(7), 850; https://doi.org/10.3390/children13070850 - 24 Jun 2026
Viewed by 165
Abstract
Background/Objectives: Gram-negative neonatal sepsis remains a cause of morbidity and mortality in preterm infants, yet the relationship between early clinical severity and long-term neurodevelopmental outcomes is incompletely defined. This study aimed to characterize Gram-negative sepsis in preterm infants and to evaluate its short-term [...] Read more.
Background/Objectives: Gram-negative neonatal sepsis remains a cause of morbidity and mortality in preterm infants, yet the relationship between early clinical severity and long-term neurodevelopmental outcomes is incompletely defined. This study aimed to characterize Gram-negative sepsis in preterm infants and to evaluate its short-term and 18–24-month neurodevelopmental consequences. Methods: We conducted a retrospective observational cohort study of preterm infants admitted to a tertiary neonatal intensive care unit between 1 January 2022 and 31 December 2023. Infants with culture-proven Gram-negative neonatal sepsis, including both early-onset sepsis (EOS) and late-onset sepsis (LOS), were included. Clinical, microbiological, therapeutic, and laboratory data were collected, and survivors were assessed at 18–24 months’ corrected age using the Bayley Scales of Infant and Toddler Development. Results: Among infants with culture-proven Gram-negative sepsis, late-onset cases were more frequent than early-onset cases, and Klebsiella pneumoniae was the most common pathogen (38.0%). Multidrug-resistant organisms were associated with 52.0% of infections. In-hospital mortality was 26.0%. Major short-term complications included intraventricular hemorrhage (24.0%), severe intraventricular hemorrhage (20.0%), necrotizing enterocolitis (12.0%), bronchopulmonary dysplasia (20.0%), and meningitis (10.0%). Among survivors who underwent neurodevelopmental assessment, neurodevelopmental impairment was observed in 38.0%, most frequently affecting the language (22.5%) and cognitive (20.0%) domains. Infants with neurodevelopmental impairment had significantly lower gestational age and birth weight and higher inflammatory biomarker levels. In multivariable analyses, lower gestational age emerged as the strongest independent predictor of both mortality (adjusted OR 0.19, 95% CI 0.04–0.99) and neurodevelopmental impairment (adjusted OR 0.12, 95% CI 0.02–0.71). Conclusions: Gram-negative neonatal sepsis in preterm infants was associated with substantial mortality, severe neonatal complications, and a high burden of later neurodevelopmental impairment. Lower gestational age was independently associated with adverse short- and long-term outcomes. These findings support early recognition, targeted antimicrobial therapy, and structured neurodevelopmental follow-up in this high-risk population. Full article
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17 pages, 14285 KB  
Review
Clonal Hematopoiesis and Gut Microbiota-Derived TMAO as Candidate Amplifiers of Cardiovascular Inflammation: The CHIDT Hypothesis
by Eugenio Caradonna, Fulvio Ferrara, Lucy Costantino, Fortuna Iannuzzo, Nicola Testa, Luca Giordano, Alice Faversani, Carlo Setacci, Ettore Novellino and Emilio Vanoli
Antioxidants 2026, 15(6), 781; https://doi.org/10.3390/antiox15060781 - 22 Jun 2026
Viewed by 233
Abstract
Clonal hematopoiesis of indeterminate potential (CHIP) and the gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) are both linked to NLRP3-mediated cardiovascular inflammation, but their interaction has not previously been explored. This work proposes the CHIDT axis (clonal hematopoiesis–dysbiosis–TMAO), a feed-forward mechanism in which TET2 [...] Read more.
Clonal hematopoiesis of indeterminate potential (CHIP) and the gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) are both linked to NLRP3-mediated cardiovascular inflammation, but their interaction has not previously been explored. This work proposes the CHIDT axis (clonal hematopoiesis–dysbiosis–TMAO), a feed-forward mechanism in which TET2 loss-of-function CHIP- and TMAO-generating Gram-negative gut dysbiosis mutually enhance cardiovascular risk. The model proceeds in three nodes. CHIP-associated intestinal immune dysregulation promotes luminal expansion of Gammaproteobacteria, which produce both trimethylamine via CntA/CntB-mediated L-carnitine oxidation and ADP-heptose as an obligate LPS biosynthetic intermediate. TMAO amplifies NLRP3 inflammasome activation through the SIRT3 → SOD2 → mtROS pathway. The evidence base of the CHIDT model is strongest for TET2-CHIP; the proposed extension to DNMT3A-CHIP rests on indirect, associative data and requires dedicated experimental confirmation before it can be considered established. TXNIP cascade, with predicted disproportionate potency in macrophages epigenetically primed by TET2 haploinsufficiency. High concentrations of TMAO have also been shown to suppress TET2 expression in endothelial cells through CYTB promoter hypermethylation, inducing NLRP3–GSDMD-dependent pyroptosis, although it remains unclear whether physiological TMAO levels can trigger this effect. Concurrently, ADP-heptose activates the ALPK1–TIFA–NF-κB pathway in bone marrow progenitors, favoring the expansion of mutant hematopoietic stem and progenitor cells. The model identifies three potential therapeutic strategies: NLRP3 inhibition, microbial TMA lyase inhibition, and microbiome-targeted reduction in Gram-negative bacteria. None has been tested in CHIP carriers stratified by plasma TMAO. Further studies in preclinical models and human cohorts integrating CHIP genotyping and TMAO quantification are needed to validate the CHIDT axis as a target for precision cardiovascular prevention. Full article
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16 pages, 4816 KB  
Article
Bioorthogonally Cross-Linked Injectable PEG Hydrogel with Robust Hemostatic and Antibacterial Properties
by Jun Zhai, Qiwen Huang, Lei Ni, Chenming Li, Li Hao, Jian Chen, Cheng Chi, Risheng Li, Yong-Miao Shen, Ronggui Lu and Zhijun Zhang
Gels 2026, 12(6), 556; https://doi.org/10.3390/gels12060556 - 20 Jun 2026
Viewed by 218
Abstract
The rapid hemostasis of deep and irregular wounds is of great clinical significance. In this study, an injectable hemostatic hydrogel based on bioorthogonal conjugation was developed. This gel uses thrombin (TMB) as the hemostatic active substance and 4ARM-PEG-N3 as the crosslinking agent, [...] Read more.
The rapid hemostasis of deep and irregular wounds is of great clinical significance. In this study, an injectable hemostatic hydrogel based on bioorthogonal conjugation was developed. This gel uses thrombin (TMB) as the hemostatic active substance and 4ARM-PEG-N3 as the crosslinking agent, which undergo orthogonal conjugation via the classic azide–alkyne click reaction to form an injectable hydrogel (TMB-PEG). The resulting hydrogel exhibited a transparent, injectable gel state. TEM images revealed that the hydrogel comprised sheet-like structures and interwoven fibers with a diameter of approximately 100 nanometers. In a puncture bleeding wound model, hemostasis with the TMB-PEG hydrogel required only 25 s, with a blood loss of 1.9 ± 1.3 mg, both approximately one-sixth of that of the control group. Moreover, the hemostatic performance of the TMB-PEG hydrogel was far superior to that of three other commonly used hemostatic materials. Furthermore, cephalosporin antibiotics were conjugated to the hemostatic gel via orthogonal reactions, endowing it with significant broad-spectrum antibacterial activity, achieving over 99% antibacterial efficacy against both Gram-negative and Gram-positive bacteria. Full article
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22 pages, 2592 KB  
Article
Intravaginal Probiotics in Transition Dairy Cows: A Randomized Multi-Farm Field Trial on Health and Milk Production
by Eduardo Rosales Barahona, Andre Luiz Garcia Dias, Ashley Egyedy and Burim N. Ametaj
Vet. Sci. 2026, 13(6), 595; https://doi.org/10.3390/vetsci13060595 - 18 Jun 2026
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Abstract
Uterine infections (metritis and endometritis) are a leading cause of culling and reproductive failure in transition dairy cows, and antibiotic-resistant Gram-negative pathogens limit conventional therapy. This randomized, controlled, multi-farm field trial evaluated whether four intravaginal infusions of a host-adapted lactic acid bacteria (LAB) [...] Read more.
Uterine infections (metritis and endometritis) are a leading cause of culling and reproductive failure in transition dairy cows, and antibiotic-resistant Gram-negative pathogens limit conventional therapy. This randomized, controlled, multi-farm field trial evaluated whether four intravaginal infusions of a host-adapted lactic acid bacteria (LAB) cocktail (Lactobacillus sakei FUA3089, Pediococcus acidilactici FUA3138, P. acidilactici FUA3140; 108–109 cfu/dose) at −3, −2, +3, and +4 weeks relative to calving reduce periparturient disease and improve milk production. A total of 526 pregnant cows (426 Holstein, 100 Jersey) from four commercial Alberta farms (automatic-milking, parlor, and certified-organic systems) were block-randomized within farm and parity to TRT1 (saline; n = 175), TRT2 (saline + skim milk; n = 176), or TRT3 (LAB cocktail in saline + skim milk; n = 175). Uterine infection incidence was assessed by Metricheck™ mucus scoring and transrectal ultrasonography at +3 and +4 weeks postpartum. Across the principal peripartum infectious outcomes, TRT3 showed a consistent protective effect: uterine infection incidence was lowest in TRT3 (18.8% vs. 25.1% in pooled controls; OR = 0.69; 95% CI, 0.44–1.09; an approximately 25% relative reduction; exact p = 0.12), and this metritis signal was additionally supported by a repeated-measures mixed model accounting for farm, parity, and week (p = 0.0175), although the Bonferroni-adjusted pairwise contrasts were tendencies (adjusted p ≈ 0.12), and the effect did not differ by parity (treatment × lactation interaction, p = 0.97). Subclinical mastitis was numerically lower in TRT3 than in pooled controls (5.3% vs. 8.9%; OR = 0.57; 95% CI, 0.27–1.24; exact p = 0.16), whereas retained placenta, milk fever, displaced abomasum, and lameness showed no clear cow-level treatment effect in the cow-level exact analyses. Milk yield increased significantly in multiparous cows, which produced 4.6 L/day more milk than TRT1 and 3.22 L/day more than TRT2 over the first 50 days in milk (p < 0.01 for both contrasts; treatment × parity interaction, p = 0.01). No effect was seen on milk composition, uterine involution, or reproductive performance. The trial supports intravaginal LAB as a candidate antibiotic-free prophylactic whose response depends on farm- and cow-level contexts and whose mechanisms require confirmation through microbiological and metabolic measurements. Full article
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26 pages, 3060 KB  
Article
Chemical Composition and Antibacterial Activity Against Food-Borne Pathogens of Six Essential Oils from Plants in Northeastern Peru
by Laydy Mitsu Mena-Chacon, Krizia Pretell, Angel F. Huaman-Pilco, Yuriko Saavedra, Aline Camila Caetano, Diner Mori-Mestanza, Robin Oblitas-Delgado, Carlos A. Amasifuen-Guerra, Rocio Jara-Vilca, Roberth Esteve Iliquin-Fernandez and Segundo Chávez-Quintana
Pharmaceuticals 2026, 19(6), 951; https://doi.org/10.3390/ph19060951 (registering DOI) - 18 Jun 2026
Viewed by 424
Abstract
Background: Essential oils (EOs) are promising natural antimicrobials against food-borne pathogens, yet their efficacy depends on complex chemical profiles that vary by species and origin. The evaluation of underexplored aromatic plants from the Peruvian Amazon may reveal novel bioactive agents. Methods: We chemically [...] Read more.
Background: Essential oils (EOs) are promising natural antimicrobials against food-borne pathogens, yet their efficacy depends on complex chemical profiles that vary by species and origin. The evaluation of underexplored aromatic plants from the Peruvian Amazon may reveal novel bioactive agents. Methods: We chemically characterized six EOs from Aloysia citrodora, Arracacia xanthorrhiza (two cultivars), Baccharis genistelloides, Piper acutifolium, and Piper lanceifolium using GC-MS and assessed their antibacterial activity against Escherichia coli (ATCC 25922), Salmonella enterica (ATCC 14028), Enterococcus faecalis (ATCC 29212), and Staphylococcus aureus (ATCC 49476). Results: EOs of Aloysia citrodora and Arracacia xanthorrhiza cv. Yellow exhibited the strongest inhibition, effective against both Gram-positive and Gram-negative bacteria, potentially associated with higher relative abundances of oxygenated monoterpenes and aliphatic aldehydes. Dose–response analysis supported their superior antibacterial potency, with the lowest LD50 values observed for these oils. Oils rich in sesquiterpenes showed lower activity. Conclusions: These findings underscore the importance of EO chemical composition for antibacterial potency and suggest that select Amazonian EOs have potential as natural preservatives for food safety applications. Full article
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