Search Results (367)

The development of dual-acting hybrid antibiotics is a promising strategy to combat the ongoing spread of drug-resistant tuberculosis. Inspired by the structure of the natural dithiolopyrrolone hybrid antibiotic thiomarinol and based on the synergistic effects confirmed by checkerboard assays, we employed a molecular hybridization strategy. The dithiolopyrrolone natural product thiolutin was covalently linked to the pharmacophores of four clinical antitubercular drugs—cycloserine, linezolid, isoniazid, and pyrazinamide—through alkyl linkers of 7–10 carbon atoms via amide condensation, leading to the design and synthesis of 15 novel hybrids. In vitro antitubercular activity evaluation revealed that the cycloserine series exhibited the best activity, with MIC values as low as 1 μg/mL, followed by the isoniazid series. Cytotoxicity assays showed that all cycloserine hybrids had IC₅₀ values > 40 μg/mL against RAW 264.7 mouse macrophages, markedly lower than that of thiolutin alone. Among them, T₁-CS and T₄-CS displayed the best selectivity indices, achieving an effective reduction in cytotoxicity. This study successfully constructed a class of thiolutin–cycloserine hybrids with low cytotoxicity and high selectivity, providing a valuable molecular template for the discovery of novel antitubercular lead compounds. Full article

Background/Objectives: Although companion animals are recognized as reservoirs of antimicrobial resistant enterococci, it remains unclear whether antimicrobial resistance differs between clinical and commensal isolates, particularly for antimicrobials reserved for human medicine. This study compared antimicrobial susceptibility profiles of clinical and commensal E. faecalis and E. faecium isolates from dogs and cats, focusing on antimicrobials reserved for human medicine under European regulation and EMA/AMEG classification. Methods: A total of 99 isolates (49 E. faecalis and 50 E. faecium) collected between 2022 and 2025 were analysed by broth microdilution, gradient diffusion, and disk diffusion methods. Antimicrobial resistance patterns were compared according to bacterial species and isolate origin. Results:E. faecium exhibited significantly higher resistance rates than E. faecalis, particularly to ampicillin, fluoroquinolones, erythromycin, nitrofurantoin, and vancomycin. Multidrug resistance was widespread, affecting all clinical E. faecium isolates and 72.2% of commensal E. faecium, whereas corresponding proportions in E. faecalis were 64.1% and 40.0%, respectively. Clinical E. faecium isolates showed significantly higher resistance than commensal isolates to antimicrobials commonly used in veterinary medicine, including ampicillin, fluoroquinolones, erythromycin, gentamicin, streptomycin, and tetracycline. Conversely, no significant differences were observed for antimicrobials reserved for human medicine, including linezolid, vancomycin, teicoplanin, tigecycline, daptomycin, rifampicin, and quinupristin/dalfopristin. Conclusions: The higher resistance observed in clinical isolates to veterinary antimicrobials is consistent with the selective pressure exerted by antimicrobial use in veterinary clinical settings, whereas resistance to human-reserved agents may reflect epidemiological processes that are independent of antimicrobial exposure in veterinary clinical settings. Continuous integrated One Health surveillance is essential to monitor the emergence and dissemination of these resistance phenotypes. The AMR profiles observed in companion animals further support the need for integrated One Health surveillance, combining veterinary, human, and environmental data to better understand the emergence and dissemination of resistant enterococci. Full article

Enterococcus spp. are increasingly recognized as important opportunistic pathogens in poultry production and represent a potential One Health concern because of their virulence potential and capacity to acquire antimicrobial resistance determinants. This study characterized Enterococcus isolates recovered from clinical poultry cases in Chile, focusing on species distribution, virulence-associated genes, antimicrobial resistance patterns and genes, biofilm formation, and cytolysin activity. A total of 39 isolates were identified using the VITEK^® 2 Compact system and confirmed by PCR targeting the tuf gene. Seven Enterococcus species were detected, with E. faecalis predominating (61.5%) and E. faecium following (15.4%). The virulence-associated genes asa1, gelE, and cylA were detected in 97.4%, 97.4%, and 48.7% of the isolates, respectively. Phenotypic antimicrobial susceptibility testing showed resistance mainly to tetracycline (61.5%) and erythromycin (17.9%), whereas all isolates were susceptible to vancomycin, ampicillin, chloramphenicol, and linezolid. Molecular analysis identified tetM (71.8%), ermB (66.7%), and tetL (30.8%) as the most predominant resistance genes. A significant association was observed between tetM and phenotypic tetracycline resistance (Fisher’s exact test, p = 0.010). However, no association was found between ermB and erythromycin resistance. Biofilm formation was observed in 66.7% of the isolates, although most were weak biofilm producers. Despite the relatively high prevalence of cylA, β-hemolytic activity was detected in only 5.1% of isolates, indicating an incomplete genotype–phenotype concordance. Overall, poultry-associated Enterococcus spp. circulating in Chile harbored multiple virulence and antimicrobial resistance determinants that may contribute to their persistence and adaptation in poultry production systems. These findings provide the first baseline molecular epidemiological data on clinical poultry-associated Enterococcus spp. isolates in Chile and support the need for continued surveillance and prudent antimicrobial use in veterinary medicine. Full article

Staphylococcus aureus causes infections ranging from skin and soft tissue infections to life-threatening systemic disease. The convergence of virulence determinants with antimicrobial resistance, particularly in methicillin-resistant S. aureus (MRSA), complicates management. In the United Arab Emirates (UAE), S. aureus is a major contributor to community- and hospital-acquired infections, and regional surveillance from the Gulf Cooperation Council has documented a shift toward community-associated MRSA lineages. Despite this clinical burden, granular molecular epidemiological data from the UAE remain scarce. Fifty consecutive S. aureus clinical isolates were obtained from Thumbay Laboratories, Ajman, UAE (October 2022–August 2023). Identification and antimicrobial susceptibility testing against 23 agents were performed on the MicroScan WalkAway system. Five virulence genes, namely mecA, Panton-Valentine leukocidin (PVL; lukF-S), exfoliative toxins A (eta) and B (etb), and toxic shock syndrome toxin (tst), were detected by conventional PCR. PVL was the most prevalent virulence gene (48%, 24/50), detected exclusively in pus isolates. mecA carriage, confirming MRSA, was identified in 44% (22/50), with PVL–mecA co-occurrence in 22% (11/50). eta was present in 6% (3/50), and etb and tst each in 2% (1/50). Resistance was highest for ampicillin and penicillin (86% each), while full susceptibility (100%) was retained for vancomycin, linezolid, daptomycin, teicoplanin, rifampin, Synercid, and trimethoprim. mecA carriage was significantly associated with resistance to amoxicillin, clavulanate, ampicillin, imipenem, penicillin, oxacillin, azithromycin, erythromycin, and ciprofloxacin (p < 0.05). This study provides the first integrated molecular characterization of key S. aureus virulence determinants, along with a comprehensive antimicrobial susceptibility profile in the UAE. The high PVL prevalence and substantial MRSA burden highlight the need for structured regional surveillance and antimicrobial stewardship, while retained susceptibility to last-resort agents offer actionable guidance for empirical therapy. Full article

MRSA is an important antimicrobial-resistant pathogen reported in a wide range of animal species; however, information regarding its occurrence in captive large felids remains limited. This report describes the detection and characterization of MRSA associated with a dental abscess in a captive jaguar (Panthera onca) from a zoological collection in Romania. A 10-year-old male jaguar presented with clinical signs suggestive of a localized oral infection. Samples collected from the dental lesion, nasal mucosa, external ear canal, and skin surface were subjected to bacteriological examination. Bacterial isolates were identified using conventional microbiological methods and Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Antimicrobial susceptibility testing was performed using the VITEK^® 2 system, while molecular confirmation was achieved by PCR targeting the nuc, mecA, and mecC genes. All isolates were identified as S. aureus and demonstrated a methicillin-resistant phenotype. PCR confirmed the presence of the species-specific nuc gene and the methicillin-resistance determinant mecA, while mecC was not detected. The isolates exhibited resistance to multiple antimicrobial classes, including β-lactams, fluoroquinolones, and macrolides, while remaining susceptible to linezolid, vancomycin, teicoplanin, rifampicin, and tigecycline. This case documents the occurrence of MRSA in a captive jaguar and highlights the value of integrated microbiological and molecular investigations for the diagnosis and characterization of resistant bacterial infections in zoological species. Full article

Background: Staphylococcus aureus bloodstream infection remains a major clinical challenge because of its association with invasive disease, antimicrobial resistance, biofilm formation, and substantial mortality. Local susceptibility surveillance is essential for guiding empirical therapy and antimicrobial stewardship. This study evaluated the epidemiology, resistance patterns, turnaround time, and clinical correlates of S. aureus bacteremia in a Romanian tertiary-care hospital. Methods: We conducted a retrospective, single-center observational study including all consecutive adults with positive blood cultures for S. aureus admitted to Sibiu County Clinical Emergency Hospital between 1 January 2024 and 31 December 2025. Demographic, clinical, microbiological, antimicrobial susceptibility, and outcome data were extracted from electronic medical records. MRSA was defined phenotypically, while MDR and XDR phenotypes were classified according to standard resistance definitions. Between-year comparisons and regression analyses were performed to explore factors associated with mortality, MRSA, and MDR status. Results: During the study period, 11,578 blood culture sets were processed, of which 2472 (21.3%) were positive; S. aureus accounted for 314 isolates (12.7% of positive cultures). After one isolate per patient was retained, the final analysis included 142 patients with S. aureus bacteremia. Median age was 70 years, 55.6% were male, and 67.6% lived in urban areas. Overall mortality was 33.1% (47/142). MRSA was identified in 39.4% of cases and MDR in 49.3%, while no XDR isolates were detected. The most frequent resistances were observed for penicillin (75.9%), erythromycin (66.2%), clindamycin (46.5%), tetracycline (45.1%), and oxacillin (38.0%). Full susceptibility was preserved for vancomycin, linezolid, ceftaroline, daptomycin, and mupirocin. Turnaround time significantly improved in 2025 compared with 2024 (median 71.4 h vs. 66.3 h; p = 0.004). In adjusted analysis, acute or chronic kidney disease was independently associated with mortality, whereas MRSA and MDR status were not independent predictors of death. Conclusions: In this single-center cohort, S. aureus bacteremia was associated with high mortality and a substantial burden of MRSA and MDR phenotypes, although preserved activity of key anti-staphylococcal agents was observed. These findings support the need for continuous local resistance surveillance, rapid microbiological diagnosis, and stewardship-guided treatment strategies. Full article

Object: Postoperative infection is a severe complication after pediatric cardiac surgery, which is closely associated with sepsis, multiple organ dysfunction, prolonged mechanical ventilation, extended ICU stay and increased mortality. Conventional microbiological tests (CMT) are limited by low sensitivity, long turnaround time, and poor capacity for detecting viruses and polymicrobial infections. This study aimed to compare the diagnostic efficacy of mNGS with that of CMT, and to explore the impact of polymicrobial infection on clinical outcomes in this high-risk pediatric population. Methods: A retrospective cohort study was conducted on 4889 pediatric patients admitted to the PICU after cardiac surgery from January 2025 to March 2026. A total of 510 patients were diagnosed with postoperative infections, including 879 CMT specimens and 86 mNGS specimens enrolled for analysis. Pathogen detection rates, pathogen spectrum and antimicrobial resistance profiles were compared between the two detection methods. Clinical prognostic indicators including mechanical ventilation duration, PICU length of stay and the requirement for continuous renal replacement therapy (CRRT) were further compared between patients with polymicrobial infection and monomicrobial infection. Results: Respiratory tract infection accounted for 87.8% of all postoperative infections, and Gram-negative bacteria were the predominant pathogens, accounting for 65.9%. The overall pathogen detection rate of mNGS was significantly higher than that of CMT (79.1% vs. 56.5%, p < 0.001). Notably, mNGS exhibited significantly better performance in detecting viruses (37.2% vs. 5.8%, p < 0.001), anaerobic pathogens and polymicrobial infections (38.2% vs. 5.4%, p < 0.001). Patients with polymicrobial infections had significantly longer mechanical ventilation time, longer PICU stay, and higher CRRT utilization rate (all p < 0.05), indicating a poorer clinical prognosis. Gram-negative bacteria showed high resistance to penicillins and early-generation cephalosporins, but remained susceptible to carbapenems and β-lactamase inhibitor combination agents. Gram-positive bacteria showed a high resistance rate to penicillin, while maintaining 100% susceptibility to vancomycin and linezolid. Conclusions: mNGS serves as a more sensitive and comprehensive tool for pathogen detection in children with post-cardiac surgery infections, especially for viral and polymicrobial infections. Polymicrobial infection is an independent risk factor for adverse clinical outcomes. Routine application of mNGS in critically ill children may help guide targeted antimicrobial therapy and improve prognosis. Full article

Endophytic and rhizosphere bacteria have considerable potential as bioinoculants for enhancing plant growth and improving soil health. However, despite their agricultural importance, their antibiotic resistance profiles remain poorly documented. This study assessed the antibiotic resistance of 31 bacterial strains isolated from the roots, cladodes, and rhizosphere of O. dillenii growing in the coastal zone of Benin. Antibiotic susceptibility was evaluated using the Kirby–Bauer disk diffusion method according to CA-SFM/EUCAST guidelines. Depending on the bacterial genus, each strain was tested against 7 to 12 antibiotics selected from a panel of 19 antibiotics representing 14 antimicrobial classes. The results showed moderate resistance of 40–60% for linezolid and clindamycin. Low resistance of 10–39% was recorded for erythromycin and vancomycin. In contrast, the bacterial resistance to Tetracycline, Amoxicillin, Ciprofloxacin, Fusidic Acid, Gentamicin, Quinupristin–dalfopristin, Rifampicin, and Trimethoprim–Sulfamethoxazole remained extremely low (<10%). No bacterial resistance was detected against Ampicillin, Amoxicillin–clavulanic Acid, Ceftriaxone, Cefoxitin, Cefotaxime, Norfloxacin, or Imipenem. Overall, 9 out of 31 endophytic strains (29.03%) exhibited multidrug resistance. Therefore, this finding provides valuable biosafety data for the selection and registration of bacterial biofertilizers and identifies several promising strains for future agricultural applications. Full article

Background: Vancomycin-resistant enterococci (VRE) Enterococcus faecalis (E. faecalis) remains largely ampicillin-susceptible, yet broad-spectrum agents are frequently used empirically (i.e., daptomycin and linezolid). Despite its frequent susceptibility to ampicillin, VRE E. faecalis is often managed with broad-spectrum antimicrobials, raising concerns about overtreatment and antimicrobial stewardship. Resistance mechanisms vary, with vancomycin resistance mediated by vanA/vanB operons and beta-lactams by altered penicillin binding proteins. These distinct mechanisms help explain why VRE E. faecalis isolates may remain susceptible to ampicillin, supporting its potential use in clinical isolates. This study aims to describe the antibacterial susceptibility results of Enterococcus faecalis VRE and assess antibiotics use in clinical settings in a tertiary medical center. Methods: This was a single-center, retrospective, descriptive study of hospitalized and outpatient adults with Enterococcus faecalis VRE isolates identified between 1 June 2018 and 15 March 2025. We excluded individuals with concomitant non-Enterococcus faecalis VRE infections and those aged <18 years. Vancomycin resistance was defined by a minimum inhibitory concentration of >32 mcg/mL per the 35th edition of the Clinical and Laboratory Standards Institution breakpoints. Results: A total of 337 patients were screened; 114 met inclusion criteria. The cohort was 54% female, 50% Black, and 48% White, with 54% having hypertension, 36% diabetes, and 19% a history of multidrug-resistant organism carriage. The most common source of infection was urinary (67%), followed by skin and soft tissue infections and bone/joint infections (11% each). All isolates were vancomycin-resistant; 82% were susceptible to ampicillin, 84% to nitrofurantoin, 61% to daptomycin, and 70% to linezolid. Antimicrobial regimens varied, with daptomycin being the most used agent (19%). No patients in the aminopenicillin group experienced 30-day mortality, whereas two patients (3%) in the non-aminopenicillin group died within 30 days. Acute kidney injury occurred in four patients (29%) in the aminopenicillin group compared with four patients (7%) in the non-aminopenicillin group, representing a significantly higher incidence in the aminopenicillin group (p = 0.037). However, myalgia, elevated creatine phosphokinase, and thrombocytopenia were more common in the non-aminopenicillin group. Conclusions: Despite higher susceptibility to ampicillin and nitrofurantoin, daptomycin was the most used agent for VRE E. faecalis infections. These findings highlight a need for improved antimicrobial stewardship and further clinical studies to guide optimal therapy. Full article

Background/Objectives: Endophthalmitis is a devastating, vision-threatening intraocular infectious disease. Given the scarcity of long-term cohort data in Asian populations, appropriate empirical antibiotic therapy is essential to prevent irreversible vision loss. The present study aimed to identify the culture-positive pathogen profiles and antimicrobial susceptibility in endophthalmitis. Methods: This retrospective study included 90 culture-positive isolates from patients with endophthalmitis treated between January 1990 and October 2020. The etiology, clinical presentation, and antibiotic susceptibility profiles of the isolates were analyzed. Results: Forty-three isolates were Gram-positive cocci, 23 were Gram-negative bacilli, and 24 were fungi. Postoperative infections were dominated by Gram-positive cocci (72.1%). Furthermore, 47.8% (11/23) of Gram-negative bacilli and 66.7% (16/24) of fungi were recovered from endogenous endophthalmitis isolates. In patients with endophthalmitis caused by Gram-negative bacilli, visual acuity was numerically inferior at both initial presentation and final follow-up visit (p = 0.051 and p = 0.018). All isolates of Gram-positive cocci exhibited full susceptibility to vancomycin and teicoplanin, while linezolid yielded a susceptibility rate of 96.9% (31/32). For Gram-negative bacilli, over 80% of isolates were susceptible to amikacin, aztreonam, and third-generation cephalosporins, whereas carbapenems and fluoroquinolones achieved susceptibility rates exceeding 90%. Among staphylococcal isolates, ciprofloxacin resistance was significantly higher in patients older than 55 years compared with those aged 55 years or younger (71.4% versus 12.5%; exact p = 0.013). Conclusions: Postoperative infection was the leading cause of Gram-positive cocci endophthalmitis. Antimicrobial susceptibility profiles validated intravitreal vancomycin combined with ceftazidime as a rational regimen for empirical antibacterial coverage. Elevated fluoroquinolone resistance among Gram-positive cocci, particularly in elderly patients, underscores the necessity of sustained regional antimicrobial resistance surveillance and periodic reassessment of conventional topical antibiotic prophylatic protocols. Full article

Background/Objectives: Antimicrobial resistance is a major public health concern requiring integrated surveillance across human, animal, and environmental sectors. Enterococcus spp. are widely distributed opportunistic bacteria with the capacity to acquire and disseminate resistance and virulence determinants. This study aimed to characterize species distribution, phenotypic antimicrobial resistance, resistance genes, and virulence-associated traits in Enterococcus spp. from One Health sources. Methods: Enterococci were recovered from 66 samples collected in Lisbon, Portugal, between late 2022 and early 2024, including healthy and sick humans, healthy and sick animals, canteen food, surface water, and public transport surfaces. RAPD-PCR was used to assess genetic diversity among 90 isolates and select 74 representative enterococci. Species identification, resistance gene screening, and virulence gene detection were performed by PCR. Antimicrobial susceptibility was assessed by disk diffusion against 12 antibiotics using CLSI criteria. Vancomycin resistance was further evaluated by agar dilution and Etest when applicable. Results: Enterococcus faecalis predominated, representing 63/74 isolates (85.1%), followed by Enterococcus faecium (5/74, 6.8%) and other Enterococcus spp. (6/74, 8.1%). Antibiotic resistance was detected across all One Health sectors. Sick Human isolates showed higher resistance than Healthy Human isolates. E. faecium showed higher resistance than E. faecalis, and all E. faecium isolates across sectors were multidrug-resistant. Rifampicin resistance was frequent, as was quinupristin-dalfopristin resistance (excluding intrinsically resistant E. faecalis), while linezolid resistance was not detected. Resistance and virulence determinants were distributed across sectors. Conclusions: Enterococci from human, animal, and environmental sources carried antimicrobial resistance and virulence-associated traits. These findings support integrated One Health surveillance to monitor resistant enterococci across interconnected reservoirs. Full article

Multidrug-resistant (MDR) Enterococcus faecium is an opportunistic pathogen. Its resistance and virulence genes can spread through the food chain, posing risks to public health. This study investigated the antimicrobial resistance and genomic characteristics of MDR E. faecium isolated from milk samples from cows with mastitis in Ningxia between 2019 and 2024. From 2019 to 2024, 1341 milk samples were collected in Yinchuan, Yinnan, and Yinbei. MDR E. faecium was identified using plate screening, mass spectrometry, broth microdilution, and hemolysis detection. Whole-genome sequencing enabled SNP, MLST, pan-genome, and COG analyses, focusing on ARGs and MGEs. MRPP, AMOVA and PCoA were applied to compare gene communities and identify driver genes. Ninety-one E. faecium strains were isolated. Resistance to florfenicol, ceftiofur, and chloramphenicol exceeded 60%, while resistance to vancomycin and linezolid showed an overall increasing trend over the study period. Phylogenetic clustering revealed two subtypes, three clades, and 10 novel STs. Spearman correlation analysis revealed strong positive correlations among the resistance genes optrA, cfr(A), and vanF. Antibiotic resistance, particularly MDR, increased over time, and strains carried diverse ARGs and MGEs. Overall, strengthened surveillance of mastitis-derived E. faecium is warranted to support the control of bovine mastitis and safeguard public health. Full article

Methicillin-resistant Staphylococcus aureus (MRSA) is a multidrug-resistant pathogen. Long-term clinical use of linezolid readily induces bacterial resistance in MRSA. This study explored resistance evolution and related mechanisms of MRSA to linezolid under subinhibitory concentrations of rifampicin, as well as the antibacterial activity and anti-resistance potential of the combination. Synergistic effects were confirmed via the broth microdilution method, checkerboard method, and time-kill curve assay. The mutant prevention concentration (MPC) was determined to assess suppression of resistant mutant enrichment. We used a 28-day adaptive evolution model and compared resistance dynamics between linezolid monotherapy and its combination with subinhibitory concentrations of rifampicin. We analyzed the growth characteristics, biofilm formation, virulence phenotypes, and resistance-related mutations of induced strains. The combination exerted synergistic or additive effects, reducing the MPC of linezolid, narrowing the mutant selection window, and delaying resistance development. Strains induced by the combination exhibited slower growth, a greater reduction in biofilm formation, and significantly lower hemolytic activity and attenuated in vivo virulence in the Galleria mellonella infection model. Sanger sequencing revealed specific mutations in the 23S rRNA gene and the ribosomal protein gene (rplC). Linezolid combined with rifampicin synergistically suppresses resistant mutant enrichment and delays resistance evolution, providing experimental support for optimizing anti-MRSA therapeutic regimens. Full article

Background/Objectives: Reactive oxygen species (ROS) are key effectors of innate immunity but can also contribute to inflammation and tissue injury when their production is dysregulated. Although antibiotics are primarily selected for their antimicrobial activity, prolonged treatment may also influence host immune responses. However, the effects of anti-tuberculosis drugs on ROS production across innate immune cell subsets have not been assessed, especially not for novel drugs currently used against multi drug-resistant (MDR) tuberculosis (TB). Methods: Whole blood from healthy donors was incubated with seven antimycobacterial drugs used against MDR TB at sub-therapeutic, therapeutic, and supra-therapeutic concentrations. ROS production was quantified by flow cytometry using dihydrorhodamine 123 (DHR-123) in neutrophils, classical monocytes, and eosinophils under unstimulated conditions or following stimulation with Escherichia coli, fMLP, or PMA. Results: Bedaquiline and clofazimine decreased ROS production in neutrophils and classical monocytes across multiple stimuli (median values of Rh-123⁺ classical monocytes after E. coli stimulation without BDQ was 30.8% versus 24.9% with 1 µg/mL BDQ (p < 0.05, therapeutic concentration) and 31.3% without CFZ versus 19.2% with 1 µg/mL CFZ (p < 0.01, therapeutic concentration) in the same conditions). In contrast, levofloxacin and linezolid showed no detectable impact on ROS production in any cell population. Pretomanid uniquely induced a reduction in ROS generation in eosinophils and classical monocytes while sparing neutrophil oxidative burst activity, distinguishing it from other antibiotics tested (34.1% decrease in Rh-123 MFI of eosinophils between the control and PA 3 µg/mL after fMLP stimulation, p < 0.01, therapeutic concentration). Conclusions: These findings demonstrate that first line drugs against MDR TB display heterogeneous and cell type-specific effects on innate immune oxidative responses. Such differential effects on host immunity may have implications for both antimicrobial efficacy and inflammation control during tuberculosis treatment. Full article

Facklamia species are Gram-positive, catalase-negative cocci within the family Aerococcaceae. Historically misidentified as streptococci or enterococci due to phenotypic similarity and conventional biochemical testing limitations, their clinical significance remains incompletely defined. This narrative review synthesizes the current literature on the microbiology, epidemiology, clinical manifestations, diagnostic challenges, and antimicrobial susceptibilities of Facklamia infections, with emphasis on urogynecologic relevance. A structured literature search identified peer-reviewed reports of microbiologically confirmed human infection published through December 2025. These reports indicate global distribution and a broad clinical spectrum. Invasive infections were reported most often in older adults and individuals with structural abnormalities, chronic comorbidities, or recent surgical interventions; however, cases in otherwise healthy patients are described. Emerging microbiome data suggest that F. hominis may be enriched in adult females with lower urinary tract symptoms, supporting the possibility that the female urogenital tract functions as a potential reservoir and site of pathogenic activity. Antimicrobial susceptibility patterns vary, with documented resistance to penicillin, macrolides, clindamycin, and tetracyclines, and susceptibility to cephalosporins, vancomycin, and linezolid. Overall, Facklamia species should be recognized as underdiagnosed opportunistic pathogens with both invasive and urogynecologic relevance. Increased awareness, improved diagnostic identification, and systematic susceptibility profiling are needed to clarify their pathogenic role and guide appropriate antimicrobial therapy. Full article